Investigations concerning bovine tuberculosis, with special reference to diagnosis and prevention ..

.

'U. S. DEPARTMENT OF AGRICULTURE.
BUREAU OF ANIMAL INDUSTRY.

BULLETIN No. 7. rt

INVESTIGATIONS

CONCERNING

MOVINE TUBERCULOSIS,

WITH

SPECIAL REFERENCE TO DIAGNOSIS AND PREVENTION,

CONDUCTED UNDER THE DIRECTION OF DR. D. E. SALMON,
CHIEF OF THE BUREAU OF ANIMAL INDUSTRY.

PUBLISHED BY AUTHORITY OF THE SECRETARY OF AGRICULTURE.

WASHINGTON:
GOVERNMENT PRINTING OFFICE.
1894,

ongra®

Z
g |

eens

wait :

te
Dita e ld scala
oe ee ie

Road
Sats
Sita

e

SS

bite

i

Binley
iB akan
HR ae

nD)

His

Melina

is Dir web VinNi OF ye RICUL RURE:
| BUREAU OF ANIMAL INDUSTRY.

BULLETIN No. 7.

INVESTIGATIONS

CONCERNING

BOVINE TUBERCULO ols,

WITH

SPECIAL REFERENCE TO DIAGNOSIS AND PREVENTION,

CONDUCTED UNDER THE DIRECTION OF DR. D. E. SALMON,
CHIEF OF THE BUREAU OF ANIMAL INDUSTRY.

PUBLISHED BY AUTHORITY OF THE SECRETARY OF AGRICULTURE.

WASHINGTON:
GOVERNMENT PRINTING OFFICE,
1894,

a

* 4

Shenagrag

LETTER OF TRANSMITTAL.

U. 8S. DEPARTMENT OF AGRICULTURE,
BUREAU OF ANIMAL INDUSTRY,
Washington, D. C., September 10, 1894.

Srr: I have the honor to transmit herewith a report submitted by
Dr. Theobald Smith covering investigations made by himself, and by
Drs. F. L. Kilborne and E. C. Sehroeder under his direction, concern-
ing the diagnosis and prevention of tuberculosis. I also ceanisinit in
this connection a report submitted to me by Dr. E. A. de Schweinitz
on tuberculin and its use.

The researches which are the basis of these reports have been most:
carefully conducted, and the results are of great importance and interest
on account of the accuracy of the observations and the light which they
throw on the prevention and control of the most widespread and’
destructive plague that affects man and the domesticated animals.

The facts here presented do much to clear away the uncertainties:
which have confronted the practical sanitarian, and a continuation of-
such investigations, particularly if on a somewhat more extended scale,
will soon enable us to clearly define the action necessary to protect the
farmer from the ravages of the disease among his live stock and the
consumer from the danger of taking into his system the infected prod-
ucts of tuberculous animals. In such studies it is the farmer who is

most interested. Not only does he suffer the loss of his animals from

the disease; but he is among the largest consumers of meat and milk,
and, consequently, the health of himself and family is proportionately
endangered. The farmer must also suffer the inconvenience and the
greater part of the loss resulting from efforts for the eradication of the
contagion. When these efforts are made by the State, it is a question
whether this loss is not greater to the cattle owner, on account of the
inconvenience of the season selected and the damaging effects of the
publicity, than would follow from his individual action to accomplish
equally beneficial results. The time has come, therefore, for our farm-
ers to study this question carefully and decide, i in the light of the facts
published for their benefit, whether it would not be preferable to them-
selves free their herds from this plague, rather than wait the neces-

. sarily slow and often unpleasant action of the constituted authorities.

Very respectfully,
D. E. SALMON,
Chief Bureau of Animal Industry.
Hon. J. STERLING Morton,
Secretary of Agriculture.

LETTER OF: SUBMITTAL.

U.S. DEPARTMENT OF AGRICULTURE,
BUREAU OF ANIMAL INDUSTRY,
Washington, D. C., July 21, 1894.

Str: I have the honor to submit herewith some preliminary investi-
gations and studies dealing with bovine tuberculosis both from an
economic and a sanitary point of view. The former has been more or
less neglected and the demands of public health allowed to overshadow
it. It seems, however, that the difficulty is one which must be met
primarily from the agricultural side and in the interests of agriculture.
If this is successful the public health problem will have solved itself.

The articles contained in this bulletin are more or less technical inas-
much as they deal with fundamental problems. A chapter on the
practical aspect of the whole subject has been added which embodies
general suggestions on prevention. These will be readily understood
by all interested in the practical bearing of bovine tuberculosis.

It remains for me to thank Dr. Cooper Curtice, formerly New York
State cattle inspector, for the courtesy of permitting me to examine
with him about 70 tuberculous animals slaughtered under the direc-
tion of the New York State Board of Health.

Very respectfully,
THEOBALD SMITH,
Chief of Division of Animal Pathology.
Dr. D. E. SALMON,
Chief of Bureau of Animal Industry.

TABLE OF CONTENTS.

Page
CLINICAL AND PATHOLOGICAL NOTES ON A HERD OF 60 CATTLE TESTED WITH
TUBERCULIN (SOLDIERS’ HOME HERD) ...-.-.---.-.--.---..----------------- 7
Clinical part. By F. L. Kilborne and E. C. Schroeder --...-...--.-.----. 7
General history and sanitary condition of the herd ...........-..---- 7
Liston ombubercwlosis im theyberd 2220/2026 (22 22) 2222 ee 10.
Abily SE CUMMELES US cians eye faci eer mola we Seon eae fon eval 11
Other conditions associated with the tuberculin injections. ..----. 20
Conclusionsvandy succestiomsters sel 1 2s 2 ee ee sya ee 23
iPatholocicalspart: | By wbheobalds Smibhes2 222 225552 So. as eee eee 26
Summary of tuberculin reactions and autopsy notes........---.----..---- 31
Tables giving the temperature as taken before and after the injection of
UO SOMLI Sg cas ones eran eossesas Reape esearch ra NE aes te ee eg os BS 59
FURTHER EXPERIMENTAL OBSERVATIONS ON THE PRESENCE OF TUBERCLE
BACILLI IN THE MILK OF Cows. By E. C. SCHROEDER......-.---.------ 75
STUDIES IN BOVINE TUBERCULOSIS WITH SPECIAL REFERENCE TO PREVEN-
THRONES Yee hOB AED OMIM S os ee Se te ae Ve ee ae 88
Primary disease of the lungs and pulmonary glands (air infection)..----- 90
Tuberculosis of the lungs. ....--.-...--.------ TEMES Pel neI OE aa See 90
Tuberculosis of the thoracic glands..-.....----...-...-----.--------- 92
Primary tuberculosis of the lymph glands of the head and neck....-..---- 100
Primary tuberculosis of the mesenteric glands, the intestines, and the
TUR CLC sc eS, mie Se OU Ses II researc eg cee er et 103
Other organs which may be primarily Seacwal Heese a eileee Seats Deer ha es Ria See ta 105
The relation of the lymphatic system to the primary seat of tuberculosis in
COMMO Is eo GSAS ASAE AE Geta te tee esl ea es EN A A ae a et ena aah eee 107
Dissemination of tubercle bacilli within the body from the primary focus. 109
Tuberculosis of the serous membranes (pearly disease)..---..-------- 110
Dissemination of tubercle bacilli in the lymph channels--......------ 112
Dissemination of tubercle bacilli through the blood (generalized infec-
CELLO HD) eet SI ha a Nc Sa eR a ae aera 113
Infection of animals by their own tuberculons discharges (auto-infec-

TOI) Se Se Sse Oe SSE ota ea ies eee ea a as ea 116
ieredityaand étunpercwmlosisyes seac= saese ee eeaee ine se eee essen ee eee 117
The differential diagnosis of tuberculous lesion. .........----.----------- 123

Worm nodules in the small intestine -....--..---.-..----.---.------- 124
Other lesions simulating those of tuberculosis. .....-...-..---.-----. 126
SOME PRACTICAL SUGGESTIONS FOR THE SUPPRESSION AND PREVENTION OF
BoviInE TUBERCULOSIS. By THEOBALD SMITH ....--..------------------- 129
Hemoyaleoimdiseasedsamunalsy 2 2 coa shu: ee eh hak 131
General sanitary measures “us SCRE ab Noes Been Pen era 133
Tuberculosis and the public health.....:...-....---.----+.-------------- 137
Tables showing the distribution of tuberculous leer ons in the body of
TMC GLE Gy Catt lOameeryen eet cee eS a ancien ate Sen eee Sele aac anus 138
TUBERCULIN AND ITS UsE. By E. A. de Schweinitz -................-------- 157

or

‘a
LIST OF ILLUSTRATIONS.
Plate I. Dorsal aspect of the bovine lungs...............-0.-26- 2a a 5
II... Ventral aspect of the bovine lungs. -.--:~-... 2.25. 2-2. +27
III. Trachea and bronchial tubes of the bovine lungs” showing attached
bronchial glands.-..........- ob aymrave jo b Sees eg © oye eins aoe ee zee
TV... Posterior mediastinal elands 32022). 2 ceo eee ee aoe ee BSc z
VY. Section through the median plane of the head of : a cow to. a
tion of (left) retropharyngeal lymph. gland RCA MAE gee aso: 5
. 6 _

INVESTIGATIONS CONCERNING BOVINE TUBERCULOSIS.

CLINICAL AND PATHOLOGICAL NOTES ON A HERD OF 60 CATTLE TESTED WITH
TUBERCULIN. (SOLDIERS HOME HERD.)

CLINICAL PART,
By F. L. Kinporne, B. V.8., and E. C. SCHROEDER, M.D. YV.

GENERAL HISTORY AND SANITARY CONDITION OF THE HERD.

‘In the year 1869 a small number of Jersey cattle, comprising 1 bull,

1 cow, and 3: heifers, were purchased at a fair in Baltimore, Md., and
brought to: the District of Columbia, where they were added to a herd
of 25 cows of no particular breed, which belonged to the Soldiers’
‘Home. The so-called common cows were sold as rapidly as their
places could be filled by the progeny of the Jerseys and sueh of their
. own. offspring as. were sired by the Jersey bull.

‘A second Jersey bull was secured in: the year: 1874 and a third in the
year 1886. The last bull died in the year 1889, after only two days of
noticeable sickness. Previous to the introduction of the third bull the

herd had increased to double the original number of cattle, and con-
sisted exclusively of either pure Jerseys or cows in which the Jersey
strain predominated. They were amply fertile aid in good condition.
A few deaths had occurred, some from parturient apoplexy and others
‘from unknown causes, but the death rate never exceeded. reasonable
bounds.

An outbreak of abortion, which assumed a contagious form, occurred
in the year 1882, and was not overcome until a considerable number of

cows had been removed from the herd and their places filled with new
stock. One bull, 6 cows, and 3 heifers of Holstein breed and 12 com.
mon cows were bought. The former came from Clifton, Va., and the
latter mainly from Montgomery County, Md. The common cows were
again sold as soon as their places could be taken by the offspring of the
‘Holstein cattle and of the remaining Jerseys, and only the most vigor-
ous and productive of the latter were retained. The Holstein cattle
‘had the preference because the Jerseys seemed to have lost their former
vitality.

7

8

The process of thinning out the common cows, and more gradually
the Jerseys, continued without interruption, and the herd slowly
increased in number until the time of the tuberculin test, when it con-
sisted of 60 animals, the majority of which were more or less pure Hol-
stein cattle and the balance Jerseys. The general condition of the herd
was excellent, and with the exception of 2 or 3 cows it contained
nothing which was suggestive of disease on superficial examination.

A second Holstein bull, from either New York or Pennsylvania, took
the place of the first in the year 1887. The first was sold in good con-
dition, but the second was sent in 1892 to the veterinary station of the
Bureau of Animal Industry, and was found extensively tuberculous on
post-mortem examination.

In addition to the several bulls spoken of, there were at different
times several other bulls which were the progeny of and raised in the
herd.

The stables in which the herd was kept are located in the grounds of
the Soldiers’ Home. Together with an unused horse stable, a dairy
room, a number of box stalls, tool houses, storerooms, and open sheds,
they form a rectangle which incloses a paved yard not less than 100
feet long and 60 feet wide, the long diameter of which extends north
and south. All the buildings are entered through the inclosed yard.

The principal stable, which is the only structure more than one story
high, is 75 feet long and 40 feet broad, and forms the greater portion of
the eastern side of the re:tangle. The upper story is used as a hay
loft. The lower story, with the exception of a space 18 feet wide at the
northern end, is occupied by three rows of fourteen stalls each, twe.
facing each other, and separated by a passage 4 feet wide, and a third
row with its rear turned towards the other two, from which it is sepa-
rated by a space 4 to 5 feet wide.

Two smaller stables used for cattle form the southwestern angle of
the rectangle. The smaller of the two is 25 feet square and contains
two rows of six Stalls, facing each other, with a passage 3 to 4 feet wide
between. In the larger, which measures 40 by 30 feet, are two rows of
ten stalls, facing each other and separated by a passage 4 to 5 feet
wide. In the latter stable the cattle are fastened in stanchions, in the
other two by means of chains.

All the buildings are of brick excepting the second story of the prin-
cipal stable. The stalls are about 4 feet wide and have plank floors
which rest upon a layer of cement. In the rear of each row of stalls is
a covered drain with openings at regular intervals. At the head of
each stall is a trough and hay rack.

The light and ventilation are good. In the largest stable, in which
the ceiling is lowest, the latter is at least 8 feet high. This stable is
ventilated by two air shafts. Light is obtained in all the stables
through numerous glazed windows which can be opened in warm
weather. The floors are dry and kept scrupulously clean.

9

The drainage from all the stables collects in acovered cesspool which
is in the inclosed yard about 10 feet from the center of the main stable.
This pool has one objectionable feature. It is 9 feet deep and the dis-
charge pipe leading from itis only 3 feet beneath the surface, and

-henece the drainage from the stables to the depth of 6 feet stagnates
constantly in this pool and frequently gives rise to very disagreeable
odors. The discharge vipe from the cesspool empties into a neighbor-
ing creek.

Extending southeast from the main stable is a patch of ground 2 to
3 acres in extent, about five times as long as it is broad, inclosed by a
fence. This is known as the cow yard. It slopes gradually down to
within 10 to 12 feet of the creek into which the drainage from the stables
is eventually discharged. In the lower portion of the cow yard the
cattle are watered, the water being pumped from a spring into a long
trough elevated about a foot from the ground.

The lower portion of the cow yard is also used as a dumping place
for the leaves collected from various portions of the Home grounds, and
when these become mixed with the droppings of the cattle and saturated
with moisture a veritable swamp is formed, through which the cattle
must pass to reach the water.

The manure from the stables was hauled each day to a place specially
provided in the rear of the cow yard, where it remained at mosta -
few days at a time. It was used to improve the condition of such por-
tions of the Home grounds as needed fertilizing.

The spring from which the drinking water was obtained is appar-
ently well removed from any source of contamination.

During the warm months the herd was kept constantly out of doors.
At 4a. m. the milch cows were driven into the stable, milked, turned
into the cow yard with the other cattle, and from there the entire herd
was driven into pasture. About 11 a.m. all the cattle were returned
to the cow yard, the milch cows were again driven into the stable,
milked, turned back into the cow yard, and from there,with the rest of
the cattle, back into pasture. At 6 p.m.all the cattle were returned to
the cow yard, where they remained until the following morning.

When the pasturage was not good the milch cows received a small
amount of feed of one kind or another while in the stable to be milked

During the cold months the cattle were not allowed to go into pas-
ture, but were given fresh air and exercise in the cow yard, where they
remained from one to eight hours, according to the state of the weather.
The cows were milked at the same hours during the summer and win-
ter. When not allowed to go into pasture the cattle were fed a mixture
of cut beets, cut hay, and mill feed, one meal at 5:30 a. m. and another
at 2:30 p. m., and a good feed of long hay intheevening. ‘The quantity
of the mixed feed varied according to the size and productivity of the

animal, and was a half bushel at each feeding for a cow giving milk.

All the water for the cattle was obtained in the cow yard excepting
only a small quantity which was mixed with the feed. This was from

10

a cistern supplied with rain water from the roof of the main stable, at
the northeastern corner of which it. was located. .

No special restricted pasture was set apart for the cattle. A: piece
of ground from which the first crop of grass had been cut for hay was
selected every day or two, and the cattle were confined to it by herds-
men. Particular instructions were given the herdsmen not to let the
eattle drink from any creek or pond which might be near or in the
pasture.

The bulls were never turned into pasture but were confined in inelos-
ures of sufficient size to give them the needed exercise and air.

Shortly previous to the time of parturition the cows were placed in
box stalls. The calves were allowed such portions of the milk of their
dams as they needed during the first two nonths, after which they were
fed eut hay mixed with meal or bran, or were turned out to pasture.

The cows were served by the bull three months after calving, so as to -
produce one calf every twelve to fourteen months.

When bedding was needed in the stalls it consisted of leaves col-
lected on the Home grounds. No particular care was taken to train
the cattle to occupy the same stalls at all times.

HISTORY OF TUBERCULOSIS IN THE HERD.

The first definite history of tuberculosis in the herd dates back to
February, 1889. An inspector of the Bureau of Animal Industry was
directed to examine the herd, and the result was that four Jersey cows
were condemned as tuberculous. Post-mortem examination confirmed
the diagnosis. Two of the cows were killed and examined at the Sol-
diers’ Home and two sent to the veterinary station of the Bureau and
kept under observation until the time of their death.*

When the above inspection was made the man in charge of the cat-
tle was closely questioned in regard to diseases and deaths in the herd.
The information obtained at this time was of a character to lead to the
supposition that some of the former deaths were due to tuberculosis.
The cattle were again examined by a Bureau inspector in the fall and
winter of 1891 and 1892, and one Jersey heifer (No. 538) pronounced
tuberculous.

November 14, 1892, the Holstein bull which entered the herd in 1886
was sent to the veterinary station of the Bureau. He had an offensive
nasal discharge, and both submaxillary glands were greatly enlarged.
Tuberculosis was suspected, but could not be definitely diagnosed, and
hence a tuberculin injection was tried. The test was made November
15 and 16 and a positive reaction obtained. November 17 both sub-
maxillary glands were cut out and found to be tuberculous.

December 9 and 10, 1892, and January 19 and 20, 1893, the bull was
again tested with tuberculin and positive reactions obtained in both

* Bulletin No.3 of the Bureau of Animal Industry, pp. 60-62, Nos. 155 and 156.

11

-instanees. Hewas killed January 26, 1893, and the post-mortem exam-
ination showed extensive tuberculosis.*

After the first tuberculin test of the bull. had given a positive reac-

tion and theexcised glands had been found tuberculous, the view, which
had been gaining strength for some time, that tuberculosis was very
general in the herd assumed almost the character of a faet, and it was
further supperted by another careful examination of the cattle extend-
ing over two days at the beginning of December, 1893. Several
undoubted cases of tuberculosis were diagnosed, three or four times as
many more animals were distinctly to be looked upon with suspicion.
The condition. of a very large portion of the remaining cattle was such
that a diagnosis of tuberculosis. with the methods usually employed
by the practical. veterinarian could not be made. Yet they showed
little irregularities of various kinds which made it impossible, in. the
presence of so much tuberculosis, to pronounce them. certainly free
from the affection.

With matters in this uncertain state it was. concluded to seek more
reliable results from a general tuberculin test, and this was all the
more desirable because the Bureau had been. seeking a favorable oppor-

tunity for some time to test the value of tuberculin as a diagnostic
agent on a larger scale than had been previously possible.

TUBERCULIN TESTS.

A preliminary tubereulin test was made direetly after the last exami-
nation of the herd. Five cows were selected and their temperature
taken every two hours from 6 a.m. to 8 p. m. December 6, 1892. The
following morning at 6 o’elock each animal received an injection of
‘tuberculin under the skin onthe left side of the neck, and the tem-
perature was again taken every two hours until 8p. m., and once in
addition to this at 9 p.m. December 8 the temperature was again
taken at 11 .a.m.to determine whether it had returned to normal in
‘the animals which had shown an elevation the previous day. (For the

degrees of temperature, obtained per rectum, during the test, see
table, p. 59.)

The substance injected was the regular “'Tubereulinum Kochii”
imported; from Germany. It was used in a 10 per cent solution. ‘The
diluent was distilled sterile water to which one-half per cent of carbolic
acid nad been.added. Each animal received a dose of the solution
equivalent to 0.4 cc. of pure tuberculin.

The reactions following the injections were quite surprising, and
implied the presence of even more tuberculosis than had been sus-
pected. Two of the cows selected, Nos. 306 and 311, which were
included in the preliminary test particularly because of their excellent
condition and apparently perfect freedom from disease gave high reac-
tions. Cows Nos. 303 and 314 were seleeted as well-developed cases of

12

tuberculosis, and in them the reactions simply confirmed the previous
diagnosis. Cow No. 304 alone gave no reaction; she had long suffered
from a cough and was regarded as a highly suspicious case. The post-
mortem examinations made later on fully verified the results of the
test.

More extensive tuberculin tests were begun February 1, 1893. In
these it was determined to observe the cattle with sufficient care while
under the influence of the tuberculin to detect, if possible, any symp-
toms which might present themselves in tuberculous animals in addi-
tion to the rise in temperature. To do this effectually the whole herd
could not be tested at one time, and hence it was divided into sections,
and the different sections tested successively until every animal, with
the exception of only one, had passed through two tests. Sufficient
time was always allowed to pass after the first injection before the
second was made to avoid interference of the former with the latter.

The tuberculin used was of two kinds, respectively specified as
tuberculin K and tuberculin 8. The former has already been described
in connection with the preliminary test. Tuberculin S was prepared
in the chemical laboratory of the Bureau of Animal Industry by Dr.
HK. A. de Schweinitz, and was injected in a 124 per cent solution.

During the test the cattle were freated as nearly as possible in the
customary manner. Just before the test they were turned into the cow
yard for an hour, where they had access to fresh drinking water, then
they were driven into the stable where they remained until the conelu-
sion of the test. The drinking water, which at other times was
obtained in the cow yard, was brought to the cattle in the stable during
the test, and on very cold days was slightly warmed by the addition of
a quart or two of boiling water to three or four gallons of cold water.

For the first test 10 head of cattle were selected. Commencing 9 a.
m., February 1, 1893, the temperature, pulse, and respiration of each
animal were taken every hour until 9 a.m. the next morning, when
each animal received an injection of tuberculin S, immediately after
which the temperature, pulse, and respiration were again taken, and
every hour from then on until thirty-two hours had passed.

March 15, 1893, a second lot of 14 head was selected and treated in
precisely the same manner. (For a full description of each animal and
the dose of tuberculin each received, see cattle Nos. 301 to 324, pp. 31-
41; for the temperature, pulse, and respiration of the cattle during the
test, see tables, pp. 60-65.) }

An examination of the tables shows that a small, marked increase in
the frequency of the pulse often accompanies the rise in temperature
resulting from an injection of tuberculin, and that in many cases a
greater frequency in the respiration also occurs. But there is nothing
sufficiently characteristic about this to give it value as additional evi-
dence of the presence or absence of tuberculosis. The same conclusion

13

was previously reached by other experimenters with tubereulin.* Con-
sequently, in the following tests the condition of the pulse and respira-
tion was not noted. It was further observed that in few if any cases
the rise in temperature commenced before the sixth hour after the
injection, and that little or nothing was to be gained by taking the
temperature during the first six to eight hours. This fact led to a
change in the hour of making the injection from 9 a. m. to 12 p. m., in
order to overcome the unpleasant necessity of remaining with the cat-
tle all night. The temperature was then taken every hour from 7 or 8
a.m.untilll p.m. At12 p.m. the injections were made, and taking
the temperature after injection was commenced the following morning
at 6 or 7 o’clock, from which time on it was taken hourly until 10 p. m.

Cattle bearing Nos. 325 to 337, inclusive, were injected with tuber-
eulin K, March 21, 1893; cattle Nos. 338 to 346, inclusive, were injected
with tuberculin K, March 27, 1893; cattle Nos. 347 to 353, inclusive,
were injected with tuberculin 8S, April 12, 1893, and cattle Nos. 354. to
363, inclusive, were injected with tuberculin 8S, May 1, 1893. (For a
description of each animal and the dose of tuberculin given, see cattle
Nos. 325 to 363, inclusive, pp. 41-59; for the temperature of the cattle
during the tests, see tables, pp. 66-69.)

The second injections were made on the following dates: March 21,
1893, cattle Nos. 301, 302, 305, 307, 308, 309, and 310 received each an
injection of tuberculin K. March 27, cattle Nos. 312, 313, 315, 317, and
319 to 324 inclusive, received each an injection of tuberculin K.+ April
12, cattle Nos. 318, and 328 to 337 inclusive, received each an injection
of tuberculin 8S. May 1, cattle Nos. 339 to 353, inclusive, received each
an injection of tuberculin S. May 25, cattle Nos. 325, 326, 327, and
354 to 363 inclusive, received each an injection of tuberculin 8S. The
same date the following cattle also received a third injection of tuber-

culinS. The same date the following cattle also received a third injec-.° ~

tion of tuberculin S: Nos. 305, 308, 309, 315, 319, 320, 321, 322, 334, 336,
and 339. (For the temperature before and after the second and third
injections, see tables, pp. 69-74.)

Cow No. 338 was so far advanced in tuberculosis before the time for
a second injection arrived that she was killed in practically a dying
condition.

Of the 63 animals included in tne entire series of tests, 60 were exam-
ined post-mortem, and in ali but 7 lesions of tuberculosis were present.{

Before we can determine in what measure the results of the tuberculin
injections correctly indicated the presence or absence of a tuberculous

* Deutsche Zeitschrift f. Thiermed., xvi (1891), p. 99, Arbeiten a. d. kaiserl.
Gesundheitsamte, vir (1892), p. 55.

t The 5 cows included in the preliminary test did not receive a second injection in
the general tests.

{ Three cows, Nos. 325, 326, and 327, included in the tuberculin tests, were not

killed. They were private property, and strictly speaking, did not form part of
the herd.

14

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 different 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:
coustancy in the quantity of tuberculin injected, and the possible
variations in the strength; purity, and state of preservation of the’
tuberculin used.

The elevation in the temperature necessary to constitute a reaction '
has variously been given from 0.5° C, to 1° C.* (0.99 F. to L.8°F.). Butitis:

not sufficient to consider merely the number of degrees the tempera-

ture after the injection rises above the temperature before the injection.
The height reached by the temperature and the duration of the eleva-
tion certainly can not be disregarded. In estimating the reliability of
the results from tuberculin injections where the temperature after the

injection is low, Eber maintains that a rise of not less than 0.5° ©. °

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 39.5° C. (103.19 F.).+' This is a rule which we
believe it is necessary to observe. As an aid in estimating the result:

of the present series of injections, two synoptic tables of the first and=

second injections, respectively, are given below. In these will be found
the maximum temperature before and after injection, the number of
hours between each injection and the first rise in temperature, thenum-
ber of hours the temperature remained elevated, the difference in
degrees in each case between the highest temperature before and after
the injection, and the presence or absence of: tuberculesis on post-
mortem examination.

*Arbeiten aus dem Kaiserlichen Gesundheitsamte, vir (1892), pp. 84-86. See
also two footnotes in Deutsche Zeitschrift f. Thiermed,, x vim (1892), p. 325.
t Ibid. Xvu11 (1892), p. 322.

aby:

15

SBA JLOMITY 4Say OG} Avp Snoracird 043 JO TINUITXvUL oT}

+ G61 ‘PI ady ) LF +91
+ G68 81 Icy | ZF
+ s6st ‘Ge “Ady | 9°
+ E681 ‘86 “Idy | oF
ar (gard
Z'0
ee op 6c
“POT JON] 0
ap Seto paneer op "| 8'T
ae e681 ‘Zt adv | 6°2
+ e6st‘e Aine] ¢‘o 9
= S681 ‘62 PUNE | Z°T L
= E681 ‘GToune | gt L
+ gest ‘e Ale) ¢:o—
a e6gt ‘FI ady | o7 91
+ S681 ‘12 “dy | 8’ tale
zie e68t‘L ‘“tdy) 9°¢ &1
+ e681 ‘T oun | 77 91
ale E681 ‘81 IVI | o's +8
aa e680 4b “dy | eF 8
ze S681 ‘86 Ady | 2% LT
ie S681 ‘16 TVW | ¢'¢ 8
Ar e6sl ‘Fh ‘adv | o's el
ats Zeer ss ODIs | pI gL
a S681 ¢ oune| eZ 1
Af S6sl pb “adv | a'¢ LT
ab E680 ‘1% “IVI | F'¢ +8
ee 681 66 PUN | OT g
ao S681 ‘12 ‘aly | 7:0 }
+ S681 ‘SI “IVI | GF +01
Si eric eee Op." "| a:¢ 6L
ste S681 Fo IVIL | 8 °F ST
ae
| { Avp snora
-e1d ay JO
*(quesqe — 7 | TWN UII XBUt oT}
‘qmesoud eel ; uvyy Joys
++) stsoy sip wy: 18a are Oot gene ae
-noreqng Jo em oe Pen -earodute} oy
souesoad | Tor i a TEV \qompa Surmp

10 90TOSq VT

worjoolar oy
Tojje sino0y
JO toquin yy

‘ep snoracid 9} JO WNUNXVU OT} UL} AOYSIY [[S Sv 4T WotooLar 1qze UOye, SUM canyuzod uel OY} OUITZ ISL] OT} FV} SOPVOLPUL JOGUINU vB IO}Je USIS sutd VW |

“TLOLY: rattt iaqje mexyey

PAOGR ost Apwolpe pey woryoefur oT} SULMOTIOF « aInjyvIeduS} Of} IVY} Se}VOIPUL JOqUINU v IOIZe USIS SNUTUL Y ;.

Sal T LOL PCOL Fig OD iene poe = as OO ane FeEaGEee
8 6 901 0 GOT. OD eer cee elas
6 8 °COL 6 GOL “op : O&€
L G “LOL 0 SOT op--"” 666
L 6 POL 0°C0L op-"*- 86E
F 601 6°01 "op ; LGE
8 OT 6 GOT OSE 908
0 GOL USCU Ewes clita: oe eee aes Mi 99 F'0 | £681 ‘TZ IVT CGE
8 SOT (O51) etna: (era rmen cneree ODE Ses rat a Ue mice
0 F901 G*e0L Ga eae ea S$ 99 GZ'0 |-=--=-! op nee
61 0 €0L G GOL Peeae tee O Dignes
iI ¥ SOL 6 GOL gee) Beco Dens
GI 6 POL 9 OL Paes oP See
8 GOL €0L see,
L F LOL 601 eae
OL 8 °SOL 0 “€0T Sah
OL @90T QECOT ce scline ee aes or LO De ries aa en O Dine
9 8 901 F GOL S681 ‘oI “TRTAL
Oe 0 90T G-c0L | 2681 ‘2 99M
L 9 90T SUC UT Geer aes nate eee mene Drake sua ol Patrae ation Opi te)
9 6 SOL (SO) tie sl eae eis § 99 Go'0 | E681 ‘OT “TPIT
me 0 ‘90 G20 M99 770 | Z680‘L 99M.
L 8 GOT Oc Os ce slpesas tie ae ae ~*$ 989 GeT0 [777 Ones
8 “FOL F201 oh sti ie ee op >”
9 “FOL + GOL OR er il ease Oper
9 LOT F GOL “$799 G20 | €68T 3 “aa
I 0 90T 9 OT MA Z68T L 90d
Seo 8 GOL 8 LOL 00 ¢ 680°C “Wen
eta 9 ZOL @ Z0L ODS Hecieal atin ODA
0°20 G'ZOL M99 F'0 | G68T 2 900
F LOL (Arvest sierra shearer tera an 0) tla Sits al eer OD
8 901 0 20 6681 6 “qo
UL o ‘To
, ABp SNOTA
-aid omg Jo
UMUUXvVU oy}! ‘moyoof | -morool
popeedd Xo 4SLY] -UL 10978 |-aL o10Feq) j ‘ : ff
einjerodutey | oingeaed | 9. i Tsay ie ss) DO ena ‘[BULLUY JOO
at Tt A i Rear cuit ere -1aqng JO osop puw puLyy jo o7%eq ae, J N
toooefareyy| -rxeyy -1XB QL
1ojje simoy
Jo Tequamn hy

“urynoiagn, fo wonoalur 78.14 7—'V

16
FAA HH | FEEEEEEEEEEE | 44 | F44444

“kep snoraoid oT} jo wnwxeut out weqy roysty TIS SUA qT WONIOLUT Io}e UayL} SUM OLN yVIOdUI0y oO} OUT} 4SLT O49 JVI} Soy¥orpUT JequM

€68T ‘6T oun Le
e681 ‘Zloune
S681 ‘Le Av
e68t'9 ANE
£681 ‘GI oune
S681 ‘Le AVI
S6st ‘et Ajue
S681 ‘ZI oune
eteeees ops

e6st‘e AeTy
e681 ‘OL ABT
e681 ‘¢ ABTY
S681 ‘OT ABI
e68t ‘¢ ATT
geste Avy

S68T ‘61 ABT
e6gt ‘ee Av

6681 ‘6LOUN

e6sl ‘F ady
e681 ‘FL dy
e681 ‘LT oun
e681'ee “dy
e6st'9 Arne
e681 ST “ady

ASHAANSHAG Aida ddd Hindi HNdidi SoH Sidi

IDO HAND HOSOOMHAMOOMOAAHANMOOONOAHNS HO

lor)

i
°

nore

|

ASCErAr-Aandtiorin

mn

ve teeereeeeeees perteee

teeeese ss eeeees presse:
Lrdecinn Sc, see oprccts:

--- prt:

neem Sse Bago ae
ee ae eee BCR TN eee
Seat Eee
“= $700 62°0
"S$ "09 G80
aS a sates ae
a a dees G09 E70
ogeteor Sener es
iin ek, Es ee ae op

ae ate ibe, ee Pega} 0)

EM pa co Singhs LOD teen At
ie ey See ee OD Senge ee |

BBO (s) Rae
wie ie aes (ayo aa
fen Be cy en Mon te M99 FO
or ES oF es M99 €'0
fone
Sais iN@ Daca
Pernbecimnanas Gre) jIS090"
RiniP SOHO SSSD SSNs pa tle
SEE SBCOSCROEOT 53 nfo) (eF(9)

* opts
tress opens

2-28" oper
Bese op--**

e681 ‘2 adyw

op:---
orator are op-77:
seses- opeee-
£68116 “IEW
asceare Opes
{ie seg ON se
[crete oper:
terees pert

E681 1S “ART

*‘(yuasqe —

“notaqny Jo
eoueserd
Io oouesq

Buch
-10ul-yso0d
pourmexo
pus portly
uo e7BCL

“MOLJOROL

{ Avp snora
-oad oy} Jo
THN ULL BUT OT}
wey} Lomo1y
SBM O1N4
-riodule} oy
Ory Sutimp
umoryoolur eqy
1oqje S1N0l
Jo Loquim Ny

.« Aep Snora
-o1d Oya Jo
CUNT X PUL Oty
pope00x%e 4say
oanyerodmey
oy} Tey
molpoofur ony
10}j8 SINOTT
jo requ Ny

oinyeiod
-ue} UNU

einjzearod
-me} Wan

*posn umypno
-Laqiy JO o8Op puR Pury

‘morjoo fur
JO OFB

1B 19qjv USIs snd ¥ |

“UOrjoolUt OT9 1897e UOWVT

SBA 4T oulT} 4SIy oy} Avp snotacdd oy} JO WIMUIEXRUr 94} OAOGE TosTA ApvorTe pe, MOTOalUL oY} SULAMoT[OF oxnjzRacdur9} oT} YY} SOPVOIpUT JOquINU B 10}Jv WSIS SNUTUL W .

“** 98

we tette sete es ee ee eee e rece eee ee eee eeeeee cece ss Zoe

street teeeer ee eececeeeeeeeccer eres sree teeeenns TOG

Sigh cake 1}
“"* 6GE
“""" 8G€
OF En ae Sc pene
Leeds:

*[BUIIMY JO “ON

‘ponuyu0j—uynoiaqn) fo uoyoalur slug —"

17

ar E68T ‘IT ome | 1°% +2 :
ar G68T ‘ez uly pe ot Gano 8 COL GG eRe 0) URN BE OSU ORES CORDED ee tetet eee ----ge¢e
al e68L‘9 oun) 1°0 | ra eee 0 cOt GG Sieieteicicts @pPare||ecesoenooov es emossonsquscesc20 ~+---@6
as eG8E ‘8E dy | o'¢ | F | 2720T | 8 “LOT ee Ope eee te oe ere oe REE gee
+ C680 FI ady | 7'¢ ieee yacor &G ;
ae e680 ‘St ady | 0+ | +91 Sac ict
+ ees oz Ady | oe +9r Salat G6
+ e68L '9e ‘idy | 7% +r Dem BG
TT €68T ‘Zl AVI | 1°% FI P cor it aes pbc er ao
vee Gerad nace al L Cor | @ E681 ‘er “rd
ee op --- +0 I Dep 29 7a OD alate aerate
‘PATEL ION | 60 z EC COs pie geass s- opecciccccttcee eee
$b ie eee op | 2F ve 8 “COT “7777777999 Gz'0 | G9 saan leg Ren ueb
1 e681 ‘Zt udy | 8'T poner |cegeia ia ee june mee RONC LE eis see eee OT Sais nee cell sana op
ae esslie Ate! PT | ¢ TI ses ees op:
35 (saat kd GlUMP || @Yjj—= | Pees eens eoB ee | IT aa ODE
= PERT sG OUI es is ae alae sy ges waco gute ies | eed Oa
tr eosr'¢ Amp] 0 [seeesscetators sate EBLE os eae te opr =
1 e681 ‘FI ady | 3’F | er 11 S680 ‘26 “LVI
sr ess ‘Iz dw} T0— seer etree eee LG e680 et “adv
‘6 681 (2 adv | 6% HF OL Ne alice OPE
ap 68L‘T ouny| og | eT | hey ils te stabh onesie siete op-- >>
a e681 ‘8 “ae | FF FI i II | 6681 ‘22 “ABIL
fe e68l ‘2 ady | 0% rail | Or 66 C681 ‘OL “1eTT
ar C681 ‘Be ‘adv | 3° +91 y Taya hs = ir [SS ARSE Fe op.-->
oF S681 ‘1G “dv | oF eT 8 IL 681 (26 “IVT
ap 68 ‘7 adv | F's IL =) 66 681 ‘91 “IPA
Ste adil tetera ais op") 9°L 2 9L ig oh: -op---
1 g68E'¢ oun | 8-0 a =} LP ODEs
i esr ‘ady | ee +6] = Hi ieee eee Opaae
i S681 16 “ABT | GF 71 rat LP S681 ‘TS “AUT
aie E681 ‘62 PUNE | OT ¢ | CT Lg €68l'S6 “VT
L £681 16 “dy £70 I TES Rice Set LF 681 ‘TZ “IV IN
1 681 ‘81 “IRIN | 9 "6 ST } OG el 25 @prece
sede Maas Sora eee ol a 1S 6681S “eu
sl £681 Fo “IVIN | 86 +91 ; ood LF Sie es Oa ae
| ie | | LF S681 ‘Te “IVIL
| Teale = |
eae SNOLA | sep snora ypc Riya Pana fe x
“(: ody -91d oY} FO I i al
WIsqe— | E q
te ee ail “1104 CUNUITX BUT OY} eee ebay a Ale | <
+) stsoy -row-ysod | ‘uorjover| TEU} LOUSTY pepasaxe aie OO torool “mworqoo far S
: : poururexe oopn EHO nny, — PADRE STIS ahs Nate ell Ono : | 9s8at A
noreqny Fo | : FO 9PN4 | yrodurar ouq | WUgereduIey | orngeaed | orngrr0d pDosn UTR wor}o0 fur
gouosora | PUY pa, | -Wduey rae ae yy oy} wey — |-ure, urnun|-w1ag cane) LOU" JO9SOP pure puLy | oyg ours router “]BUILUB JO “ON |
Io souesqy | UoITA 9} eq, Tory, uLiMp uoroefur 9 : : q Ly skep yo i at
tmoroofur ogy Poolur ot} | -CXVyT TXB Taq un \T . is
Tayye SINOt IojFV smM0y, | D
Jo aaqumy | ¢° t°C EN | | oN
2 j | | i

uynowgny, fo uoyoalur puorag—'

18

“10T}90/UL pMOdES OM POATODAIT ~

+ COSTG LOU MET O— = [ssen ee seo) sa steerer cinc ty AO | 8 GOL Be gr era) ecco Bi POR as
ts €68T GL oune | 9°0 0°S0L | GOL ACA nie ter ee eee TG ae eS CE
13 6681 ‘26 AVI | 10 GOL | F'cOL Ops eaalina at Oe
Ap €68T ‘9 Amy} €°0 c°COL | 6 GOT bh Or aealll (LAG Ag, eel (i ates 9 TOPE os
ats E681 ‘CT euny: | FO— 0°S0L | FE0L Ue ye FG pan: LO) ke
sts e6sr ‘Le AvW | LT 6 GOT 8 TOL OD tyaEs (Ae OR Manas Opes 4
na S681 ‘EL AINE | ¢°s— ¢ GOL 0°SOT ODS emacs RGsrxe Melt eee OR aie
af E681 ‘ZLoune | 8° 8 GOT | 0'GOT ODFEATS HINEGy 1 vaste GL aa Chis
Stan lee ODS ee FEO re, 8 GOL 6 SOL ORG RG) OS Ver || Siete eee ODIs
ate 6681 ‘8 oun | +0 +g LT 0 801 9 Z0T ing E681 ‘6s ATT
a €68T ‘sg AVI | L°T Or él £ FOL 9 COL Ce ae ane ODay
+ e68T ‘or Av | ¢ 0 z = €F0T | O'F0L . pean cent op----
ate e681 ‘¢ AVI | 38 +91 | ta 9 “SOT PAGORA Os | aok fe organ §$°99 €¢"0 | 61 A) sai
a €68T ‘OL AVIT | 8°% | Elaine él 0 “SOE 6 GOL “"§$ "99 G§°0 | 6T Cy re
ae E681 ‘¢ Av | 8'T F9T ramet 8 ‘S01 ORGO DA eho tan ae ) Urn 61 OD ans
a E681 ‘€ Key OT OL ae 6 E0T 6 GOL aaa a Ue ad $ °99 ¢G'0 | 6I (0) elope
ts S681 °¢ AV 9°0 | G L G POL 9 “SOT “$99 2'0 | 6L OR te
AN €68T ‘OT AVI | 6°0 6 él cor 9 “GOL DE Ue AHS Sevees l eae
a S681 ‘ZL ABI Oia | +91 eb F90L ExCOL ee lun eae toes, © he Oe es CE oat a AC | ek 4 ae ad OD
ar EGR OTANI sR oOie ences: Sinks eri ra os wee tps S | 0 BGO Teen teccep ee < 23g) pO Dearae a |TG Gi" ine Nal cernigs Ota
aD E681 ‘ZI AVI | 9°€ Go eG OR ieee ear os kr UR ens OE aden all emai da: OPPSE
qe aeel nse OD rs) G PAS OTA Am aie toy ee So ere tO Dea nC Ci gm li emree Ops
ete S681 6L ABT | 9°% PICO Cog een. ee eee O Dita Chae Sam: cares Oana
or E681 ‘6% ABIN | F°0 GLGO Eee ir ce hn tea, AO Dare GE © = | ahontaes, op
‘ ne eI aon 90 G68 'T AVL
a Balad ete are eta (ara late teteTe tel eichatarm areharale at alicia at tarsi all arcetersiate creel eee ee oe ia alee ee ce lee ae welt see a eae
+ | 681 ‘Fa Ady | 0's +91 =) OV GOT se SOnCOs anal “§ 100 GZ 0 | 2
‘To ‘Lo ‘Ho
*Avp Snota SAE
E p Snora |
*(ymasqe | a uneeuret q| ord eq3 Jo |
oes ae “104 | Bano aaa cNuUIxBUt et) ‘moyool | ‘morool ‘morjooelut
4 SISO] -roul-ysod | *MOoTJOROT BUA OA} Paepee0X9 ISA) -UL 189JB |-UL OL0Jaq RSS GTO | 9say ARN
-notoqiny Jo peurmexe | Joopny | _ nxodur0y out eingeieduisy | ompeded | ammyeaed oan Lae er sary | OU} 2OUIS mae ao ‘yRUITUY Jo “oN
couosord | PUB PATOL | HAW loom Suramp| UF WOUA — |-t9} uIMLUT -tH9} want) 2944 F Ppae PUM! skup jo FOOTE
zo eouesqy | TOM 9". | woroolur oy} ee anen THEAl | XV | Loq wT NT
paketit 8 jo raquin | |

*penurm0g—uynowagn, fo woyoalur puovag—' gq

19

Table A gives the result of the first injections. The absence or pres-
ence of areaction supported by the absence or presence of tuberculosis is
so clear in 50 of the 60 animals examined post-mortem that they require
no special attention. This leaves 10 animals of more doubtful character,
which we will consider in order (see pp. 31-58 for complete notes):

No. 305.—The maximum temperature after injection, which is 102.8° F., is not suf-
ficiently high, although it is 1° F. above the maximum temperature previons to
injection, te pass as a reaction in a herd of 63 cattle among which 18 gave a max-
imum temperature of 102.8° F. or more before injection. Neither is the elevation
in the temperature after injection over and above the maximum temperature before
injection (only three heurs) of sufficient duration to be regarded as a reaction.
Hence the absence of tubereulosis in this animal was properly indicated by the
tuberculin injection.

No. 319.— Failed to give a reaction and on post-mortem examination was found
tuberculous. The tuberculous foci were small, largely calcareous, and the surround-
ing tissue free from recent infiltration.

No. 320.—Gave a low reaction in the absence of tuberculosis. The animal is a
heifer, which had been served by the bull every three weeks for five or six months
previous to the date of conception, February 15, 1893, just one month before the
injection.

No. 321.—The highest temperature reached after injection was 103.4° F., and
although this is 1.2° F. above the maximum temperature of the previous day, in con-
sideration of the fact that the animal was seven months advanced in her first preg-
nancy, it is not sufficient to constitute a reaction. On post-mortem no tuberculosis
was found, but the animal was affected with a liver disease.

No. 322.—No reaction and tuberculosis present. The lesions are similar to those in
No. 319.

No. 334.—No reaction and tuberculosis present.

No. 338.—No reaction and very extensive tuberculosis present.

No. 840.—A decided reaction and no tuberculosis. The animal was supposed to be
four months and ten days advanced in pregnancy at the time of the post-mortem
examination, one month after the tuberculin test, but in her uterus was found a
fetus, about three months old, dead and partly disintegrated.

No. 353.—Will have to pass as a case showing no tuberculosis on post-mortem, but
giving a very low or somewhat doubtful reaction.

No. 360.—No reaction and tuberculosis present. Similar to Nos. 319 and 322. A
guinea pig inoculated died from tuberculosis in two months.

Thus we have 52 instances out of 60 in which the presence or absence
of tuberculosis was correctly indicated by the use of tuberculin as a
diagnostic agent, giving a general average of 862 per cent.

It is questionable whether the absence of reactions in cases Nos. 319,
322, and 360 should have much weight. They must, indeed, be ranked
as failures, but they were in all probability stationary cases of disease,
dangerous neither to themselves nor other cattle. It is also interesting
to note that the two animals without tuberculosis, which must be
regarded as having given a reaction, Nos. 320 and 353, show a feebler
reaction, which commenced at a later hour and was of shorter duration
than the reaction in any animal decidedly tuberculous.

The standard of what should constitute a reaction could conveniently
be raised high enough for the herd to exclude these two cases from the
number of animals giving a reaction without increasing the number of
animals found tuberculous without a reaction.

20

An examination of Table B, which gives the results of the second
injections, will show that the first part corresponds very well with Table
A. The results in the latter portion of the table are not reliable, a fact
for which we ean account at the present time only by assuming the
existence of some defect in the tuberculin used.

Since the above was written several instances have come under obser-
vation where a second injection failed altogether to produce a reaction
in animals which gave a very decided reaction after the first injection,
notwithstanding that the two injections were separated by a very con-
siderable period of time.*

OTHER CONDITIONS ASSOCIATED WITH THE TUBERCULIN INJECTIONS.

Swelling and tenderness at the seat of injection, sufficiently severe
to be clearly noticeable, were present in less than 20 per cent of the
cattle, and were as common among the nontuberculous which gave no
reaction as among the tuberculous animals which reacted.

Muscular trembling or shivering, as if from a severe chill, noticeable
especially in the flank, was a common occurrence. It was seenin 25 to
30 animals, either after the first or second injection; some cattleshowed
this condition after the first injection and not after the second, and vice
versa. It accompanied as a constant feature neither the highest reac-
tions nor those of longest duration, nor was it confined to animals with
lesions of a particular kind in character or extent. The most interest-
ing feature about it is that wherever it was seen lesions of tuberculosis
were found on post-mortem examination.

A decided softening of the feces, an acceleration of the pulse and res-
piration, arching of the back, coldness of the hind quarters and extrem-
ities, loss of appetite and temporary suspension of rumination, the latter
during the time the fever was greatest, are conditions which were
observed in aconsiderable number of animals, but like the swelling and

*Quite recently 6 cows received an injection of tuberculin, which was followed in
twenty-four days by a second injection. The following table gives the results of
the two injections. For the first injection tuberculin S was used; for the second
tuberculin K. Only one animal (No.5) included in the table was pregnant; it was
her fourth pregnancy, in which she was five months advanced at the time of the last
injection. It is to be regretted that the animals included in the table could not
have been killed and examined post-mortem.—E. C. 8S.

| : : Highest .
Highest Highest Sena. | Highest | 4a > 3
| No. | tempera- tempera- panei tempera- er ie Reyve
of | ture be- |ture after, PUTe | © ture after Bacar peas
| cow. fore first | first in- picieg od second aoe aie spe
injection. jection. saeticiad injection. edi) | PERS geet
}
oF, ° 0 Git) -OsR on

1 102.8 106. 2 101.9 104.8 3.4 2.9 |
2 104. 0 106.5 101.7 102. 0 2.5 0.3 |
3 102.8 104. 0 102.3 105.1 1.2 2.8
4 101.4 104.8 101.8 106. 4 | 3.4 4.6
5, 101.8 104. 0 102. 4 104.7 2.2 | 2.3

{ 6 102.6 106. 0 102.1 104. 0 | 3.4 1.9

21

tenderness at the seat of injection, they have apparently no practical
significance.

So far as it was possible to observe, no unfavorable condition was
produced in any animal by the tuberculin injections. In regard to this
matter most observers are agreed.*

A reduction in the milk secretion, if this occurred, was only tempo-
rary, and too small in amount to attract attention in a large herd of
which only a comparatively small number of cattle were under the influ-
ence of the tuberculin at one time. Itisreasonable to suppose that the
quantity of milk from cattle affected by a loss of appetite was slightly
diminished in consequence of the smaller amount of food consuined.
The reduction in the milk secretion observed in cattle tested with tuber-
eulin in Karlsruhe and Mannheim was attributed to this cause and to
the disturbance of the animal while undergoing the test.t A decided
reduction in the milk secretion was observed in cattle tested in Berlin,
but the specific gravity of the milk remained unaffected. §

* Deutsche Zeitschrift f. Thiermed, xvii (1891), p.97. Arbeiten a. d. Kaiserlichen
Gesundheitsamte, vill (1892), p. 86.

t Ibid., p. 86.

t Ibid., pp. 40, 41.

§ The amount of milk secreted hy 65 to 70 cows in a herd of 134 cattle which were
injected with tuberculin in Virginia was 800 pounds the day before and 750 pounds
the day after the injection. In 71 percent of the herd the injection was followed by
a reaction.

Unfortunately this herd could not be kept under observation a longer time than
the tuberculin test actually required to determine the number of animals aftected
with tuberculosis. and hence no exact data could be secured on the amount of milk
secreted by the cows during the first eight to ten days after the injection. On this
last point the manager of the herd informs me that a reduction in the amount of
milk commenced the day after the injection, that it was progressive during several
days, and reached its climax the fourth or fifth day, and that the daily amount of
milk then increased again until it reached its normal about the tenth day.

In this connection the following table may be of interest. It includes 6 cows,
each of which was injected with 0.3 cc. of tuberculin K. The amount of reaction
(the difference between the highest temperature the day before and the day after
the injection) is given in degrees F., aud the amount of milk in pounds the day
before and after the injection.

Zeduction |
Nah Con Amount of Milk before Milk after in milk
‘ . reaction. injection. injection. atter injec- |
| tion. |
dese as eS. 2.9 16.1 15.0 iat
PS ee Rae peer 0.3 27.1 27.8 SUNT
Beas te Sew ee 2.8 17.7 16. 2 US) |
és" RE saat te rae 4.6 221.5 17.1 5.4 !
| eae eee eee 2.3 | 17.3 17.1 0.2
Gees sere 1.9 30.9 29.1 1.8
eee ee 3 my
Motalieaes|sees ose. cs 131.6 122.3 93

Of the above cows all, except No.5, had calved within the last two to five months,
and were not pregnant. No. 5 had calved eight months previous to tie test and was
five months advanced in pregnancy.

In another herd in Virginia, in which 15 cattle were injected with tuberenlin, and
70 per cent of the milk cows reacteil, a marked reduction in the amount of milk yield
during the first few days after the injection was reported.—E. C. S.

22

Tn our test we made no examination of the urine. In the Berlin tests
already referred to it was observed that the specific gravity remained
uninfluenced, but that the alkalinity and the amount of sodium chloride
were increased in almost every case, in tuberculous as well as non-
tuberculous cattle. This condition was very marked the second day
after the injection, and reached its highest point the fourth day. The
increased alkalinity and the increased amount of sodium chloride did
not keep pace with each other, so that when the alkalinity had reached
its highest point a reduction occurred in the sodium chloride and
inversely.*

All the injections with tuberculin in cattle published up to Mareh
15, 1892, have been included in a general résumé by A. Eber.t He
describes the various conditions it is necessary to observe in experi-
ments the purpose of which is to determine the value tuberculin pos-
sesses as a diagnostic agent in tuberculosis. The conditions are much
the same as those now generally accepted, and correspond fairly well
with the conditions we have observed in our work. After applying
them to the tuberculin injections with which his résumé deals, he finds
443 cases sufficiently free from objectionable features to answer as
material for reliable conclusions. Of the 443 animals injected, the
condition as regards tuberculosis was correctly determined in 375 cases,
which is equivalent to 15.35 per cent of failures. The result of the
first injections in the Soldiers’ Home herd compares favorably with
this, and while it is a rate of failures too: high to give more than par-
tial satisfaction, it is so great an improvement over all other known
methods by which tuberculosis can be diagnosed that the importance
of tuberculin can hardly be too highly estimated. It must also be
borne in mind that the eight animals in the Soldiers’ Home herd in
which the tuberculin is represented as having given false results are, -
with one exception, involved in a degree of doubt. Nos. 319, 322, 334,
and 360, which gave no reaction, certainly were not free from lesions
of tuberculosis, but in 3 of the 4 animals there was no recent infiltra-
tion, and if the lesions in all tour animals had been concentrated in
only one animal, they would still have been too slight to have given
the remotest intimation of their presence where their detection depended
on the usual methods of examination. The absence of tuberculosis in
Nos. 320, 340, and 353 is questionable in the presence of the reaction
after injection with tuberculin, in the sense that absence here may
mean, simply, not found after careful search. Because of economical
considerations the carcasses of the cattle in which the lesions were
Slight, or apparently absent, were not mutilated to any extent which
would have destroyed their value as food.

The absence of a reaction in No. 338 is peculiar; it was an advaneed
case of tuberculosis, in which the affection was readily diagnosed almost

: Tbid., p. 5d.
t Deutsche Zeitschrift f. Thiermedicin, xvii (1892), p. 321.

23

a year previous to the injection. Other observers have noticed that
occasionally very advanced cases of tuberculosis fail to react, and that.
the reaction is frequently highest in young animals in the first stages
of the disease.*

CONCLUSIONS AND SUGGESTIONS.

It is not necessary to repeat the many favorable opinions expressed by
different observers in support of the value which is claimed for tuber-
culin 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 tuber-
culin can not fail to recognize its importance.

The precise composition of tuberculin is unknown, its exact qualities
have not been determined, and the methods used to test its strength
and purity are imperfect. With further improvement in these respects
we may expect more accurate results from tuberculin injections in the
future.

To make a tubereulin test for practical purposes we believe it neces-
sary to observe the following rules. In laying down these few simple
rules we have kept in mind that it is desirable, from an economical point
of view, tostrip every test for practical purposes of all unnecessary labor
or expenditure of time.

The temperature of the animals to be tested should be taken every
two hours at least six or seven times before the injections are made,
because without a knowledge of the variations before the injections it
is frequently impossible to estimate correctly the value of the eleva-
tions after the injections. This precaution may have the appearance
of an unnecessary waste of time and labor where the temperature before
the injections varies only within what are usually regarded strictly
normal limits for cattle. But the temperature does not always confine
itself within these limits, and strictly normal limits for one herd and
one set of conditions are not strictly normal limits for all herds and all
conditions, and the exceptions, which certainly can not be justly
neglected, can be selected only by a number of accurate measurements.

The importance of this rule will become more apparent if we turn to
the temperature tables and examine the temperature previous to injec-
tion of the 14 animals in which a height of 103° F. was reached.

The following table gives the numbers of the 14 animals, the highest
point reached by the temperature before the injection and the hour in
which that point was reached, the temperature of each animal at 9

*Arbeiten a. d. kaiserlichen Gesundheitsamt, vit (1892), pp. 54 and 55. The
Journal of Com. Med. and Vet. Arch., Vol. xv (1894), p. 13.

24

a.m. the same day, and the difference in degrees between the highest
temperature and the 9 a. m. temperature.

Highest tem |Tempera-| Differ- Highest tem- ‘Lempera-| Differ-
peraturebefore| ture, | ence be- perature before ture, ence be- |
No.of | thefirstinjee- 9a.m., tweenthe No.of | thefirstinjec- | 9a.m., |tween the,
animal. | tion and the before | highest animal. tion and the before | highest
hour of oceur- | firstin- | and hour of oceur- | first in- and
rence. jection. | lowest. | rence, jection. | lowest.
° F. ie) t 5 ie) e. e | °
312 | 103.0— 4p.m.} 100.0 3.0 329 | 103.0— 6p.m.| 100.6 | 24
317 | 103.0— 5 p.m. 101.0 | 2.0 338 | 103.6— 2p. m. | 102. 2 | 1.4
318 | 103.0— 6 p.m.| 98.8 | 4.2 342-103. 0—10 p>. m | 10:.8 | 12,
319 | 103.3— 5 p.m. | 99 8 | 3.5 352 | 103.0— 6 p.m. |} 102.6 0.4
323 | 103.5— 5 p.m. 99.7 | 3.8 354 | 103.5— 6p.m.| 101.8 ie Fe
324 | 104.0— 5 p.m. | 101.0 | 3.0 359 | 103.2— 6 p.m 101. 2 | 2.0
8 | 0.2 363 | 105.2— 6 p.m LOL. 9 | 1.3

327 | 103.0—11 a. m. |} 102. 8

We have here 14 animals which, with the exception ot Nos. 324, in
the last stages of pregnancy, and 338, a case of tuberculosis diagnosed
previous to the test, gave no evidence of an affection or a condition
accompanying which a great variation in temperature, or an unusually
low or high temperature. could be expected; and yet, if these animals
had received an injection of tuberculin between 9 and 10 a. m., the day
the temperature in the tables was taken, and the presence or absence
of areaction later in the day had been determined from the state of the
temperature at 9 a.m., even if the tuberculin in the supposed injections
had been absolutely inert, at least three-fourths of the animals would
have been looked upon as giving decided reactions.

The degrees of temperature above given were all taken previous to
the first injections. If we now turn to the temperature of the same
animals taken previous to the second injections, we find that in eight
of them very similar variations exist, and that only two of them have a
really normal temperature, showing clearly that in many individuals
the variations are sufficiently constant to make their determination by
precise measurements practically necessary in every tuberculin test
from which reliable results are expected. In other words, the varia-
tion in the temperature of an animal during the course of a day is fre-
quently so great that, if this variation is not determined, and the tem-
perature is taken only once previous to a tuberculin injection, it is
merely a matter of chance if a high temperature, natural to the animal
and independent of the action of the tuberculin injection, is not con-
founded with or erroneously taken for a reaction.

Special stress is laid on this point because, in a recent article which
speaks of the use of tuberculin, the opinion is expressed that while
a long series of temperatures before injection may be more scientific,
a single temperature before injection at 9 p.m. is sufficient for prae-
tical purposes.*

An examination of the degrees of temperature of the 24 animals
included in Tables II to LX, which were taken during twenty-four con-

ew) Sh eS

¥

25

secutive hours previous to injection, will show that the maximum daily
temperature was reached four times at 8 a. m., twice at 3 p. m., eight
times at 4 p. m., eight times at 5 p. m., once at 6 p. m., and once at 9
p.m. The minimum temperature, with two exceptions, occurred before
the hour of noon. Hence, while it is probable that the chances tor
error with a single temperature befere the injection are less when that
temperature is taken in the evening, or, better still, in the afternoon
between 4 and 5 o’clock, it 1s clear, with the maximum daily tempera-
ture varying in the hour of its occurrence all the way from 8 a. m. to
9 p. m., that the hour at which a single temperature is taken does not
signify much, and that it is insufficient in many, if not in all, cases for
reliable conclusions..

Next comes the tuberculin, and this unfortunately, which is the most
important consideration, 1s beyond the control of the inspector. The
domestic tuberculin, with which our experience is largest, has cer-
tainly shown some peculiarities which are best explained by assuming
a variation to exist in the strength of preparations of different dates.
The imported tuberculin has given fairly constant results in our hands,
but we have not used it with sufficient frequency to say that it is bet-
ter than the domestic article. Dr. Curtice, whose experience with the
foreign substance is more extensive, gives some reasons to doubt the
constancy of its strength.*

The tuberculin should be properly diluted. One part of tuberculin
to 9 parts of water containing from one-half to 1 per cent of carbolic
acid has found general favor. The tuberculin prepared by the Bureau
of Animal Industry is diluted in the form of a 124 per cent solution
before it leaves the laboratory, and is ready for injection as received.

The dose, if the tuberculin is of the usually supposed strength, is
from 4 to 5 cc. (about 1 to 14 drams) of the 10 per cent solution of the
unported tuberculin, or from 2 to 24 cc. (about one-half to three-fourths
dram) of the 124 per cent solution of the Bureau tuberculin, for an adult
animal of medium size. In our work we have found the Bureau tuber-
culin to be a little stronger than the German tuberculin.t

The point at which the injection is made seems immaterial. The
most convenient place is the side of the neck where the skin is thin,
and a large, strong needle gives much more satisfaction than a small,
fine one.

After the injection the temperature should again be taken in eight
or ten hours, and from then on every two hours until a decided reac-
tion, continuous during several hours, has occurred, or until eighteen
or twenty hours have passed since the time of the injection.

In the Soldiers’ Home herd the temperature, which commenced to
rise before the tenth hour, generally remained elevated from ten to six-
teen hours. The temperature, which remained practically equivalent

~ The Journal of Comp. Med. and Vet. Arch., xv (1894), p. 13.
t Quite recently other veterinarians have been using yery small doses.

26

to the temperature of the previous day until fourteen or sixteen hours
after the injection, never rose high enough or retained its elevation
long enough to be taken as a reaction. Nothing will be lost, therefore,
by waiting ten hours before taking the first temperature after the
injection, or by discontinuing to take the temperature after eighteen
to twenty hours.*

In anumber of tests made by us for practical purposes only, the
temperature of the cattle was taken before the injections every two
hours, from 8a.m. to 5 p.m. The injections were made at 10 p. m. and
the temperature after the injections was again taken the following day
at 8 a.m., and continued every two hours until $8 p.m. In the herds
tested in this manner only the animals which gave reactions were
killed, and thus far we have yet to meet the first case which reacted
and did not show tuberculosis on post-mortem examination.

PATHOLOGICAL PART.

By THEOBALD SMITH.

The post-mortem examinations of the sixty animals in this herd were
made by the writer with the assistance of Drs. Kilborne and Schroeder.
Great care was exercised in order that accurate information might be
gained concerning the true significance of the results obtained with
tuberculin published in the preceding pages. Incidentally, however, a
number of interesting facts were observed, some of which have been
casually mentioned by other writers, but without that emphasis which
is due them as elucidating the channels of infection. Fortunately many
of the animals were still in that stage of the disease which permitted
the accurate determination of the original focus of infection. Autop-
sies upon tuberculous cattle are made mainly when the tubercular virus
has become pretty generally disseminated 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 an incipient or quiescent stage it
is hidden away in the lymphatic glands, and unless a thorough search
is made through every gland in certain regions of the lymphatic sys-
tem, 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.

The autopsies in the herd under investigation were limited to the
head, the thorax, the abdomen, and the glands of the limbs. Owing to
the amount of time spent in searching through the other parts of the
body, the brain was not examined in all cases. Inasmuelh as this

* When very small doses of tuberculin are used these rules may not hold.

27

organ is not likely to be primarily affected, and tuberculosis of the
ceutral nervous system is quite rare, the inferences and conclusions
that may be drawn will not be affected by this omission.

Before discussing the lesions more in detail I deem it desirable to
call the attention of the reader to pages 139 and 140, which give, in
tabulated form, the distribution of the disease in the body as shown
by the organs and structures involved. The table needs no explana-
tion beyond the statement that the entire distribution of the disease is
given, nothing being omitted which came to light at the autepsy. The
diagnosis, where any doubt existed, was made by the microscopic
examination of sections. In several cases guinea-pigs were inoculated
to test the vitality of the virus in cheesy material.

The first thing that will strike the reader as remarkable in looking
over these tables is the high percentage of infection in a herd in which
not more than 5 or 6 showed evidence of disease. The concealed char-
acter ot the affection was not always limited to the very mild infections,
but in some cases considerable lung disease remained unobserved dur-
ing life. Of the 60 animals killed only 7, or about 12 per cent, were
free from all traces of tuberculosis. In the remaining 55 the disease
varied very much in intensity, ranging from the smallest, probably
quiescent focus in one of the thoracic glands, to advanced tuberculosis.

In order to present these cases more intelligibly I shall discuss, in
the order named, (1) tuberculosis of the glands of the head and neck,
(2) of the thoracic organs, and (3) of the abdominal organs.

In the head the disease was restricted mainly to the retro-pharyn-
geal glands (Glandule tracheales seu cervicales superiores |profunde] ).
These glands are easily reached after removing the tongue, and itis con-
venient to remove them together with the tonsils for examination.
From the table it will be seen that these glands were diseased in 9
cases \17 per cent). In 5 they contained the only foci discoverable.
In the remaining 4 disease of other structures also was present.
The submaxillary lymph glands were free in all cases. In one case
(No. 315) the tonsils and one parotid lymph gland were tuberculous.

The retro-pharyngeal glands, situated dorsad and to one side of the
pharynx and larynx, receive the afferent lymphatic vessels from the
parotid and the submaxillary lymph glands* and hence the territory
drained by the lymphatic vessels, which finally enter these glands,
includes the mucous membrane of the mouth and nose, in other words,
of the entire portion of the respiratory and digestive tract lodged in
the head and upper portion of the neck.

In the five cases in which tuberculosis of the retro-pharyngeal glands
was the only discoverable focus (Nos. 309, 315, 329, 344, and 352), the
tubercle bacillus must have been carried from the mucous membrane of
the mouth, nose, tonsil, or pharynx into the gland. We do not know,
therefore, whether the virus was deposited from respired air or taken .

* Encyklopidie der gesammten Thierheilkunde, v1, 216.

28

in with the food. Infection of these glands, however, is generally
regarded as introduced with the food. In case of No. 337 there was
also lung disease, and it is impossible to determine whether the infec-
tion was primary or due to bacilli coughed up from the lungs. The
same may be said of No. 345.

In No. 363, on the other hand, the infection of this gland was proba-
bly independent of the infection of the thoracic glands. The number
of cases of tuberculosis which may be overlooked, if these glands are
not examined, is by no means insignificant. In the herd under discus-
sion the 5 animals affected with primary tuberculosis of the glands of
the head (about 9 per cent) did not manifest during life any difficulties
in breathing. In fact, the glands had not become large enough to
cause any obstruction to respiration or deglutition.

The disease in the thoracic organs is of considerable interest to us,
for it confirms the statement made by other observers that most cases
of bovine tuberculosis are of pulmonary origin. This means that
tubercle bacilli are taken up mainly in the dried condition and carried
by currents of air as dust into the ramifications of the air tubes.

A glance at the table shows that out of fifty-three cases of tubereu-
losis, forty-seven, or 88.6 per cent, were affected with tuberculosis of
organs situated in the chest. The disease involved one or all of the
following structures: Bronchial glands, mediastinal glands, lung tissue
(including air tubes), pleura.

The distribution of the lesions is of considerable interest. The lungs
themselves were affected in 20 animals, while the other 27 had lesions
in either bronchial or posterior mediastinal glands, or both, without
lung disease. Taking it for granted at present that in nearly all cases
the tuberele bacilli which are lodged in the bronchial and mediastinal
glands. have passed through the lungs, the great predominance of pul-
monary infection, as compared with other channels of infection in this
herd. becomes evident.

It is of considerable importance to note that of 47 animals having
tuberculous lesions in the thorax, 27 had only gland tuberculosis. Tf,
in other words, the lungs only had been examined and the lymph
glands associated with them neglected, either in part or as a whole, 48
per cent of the cases would have been passed as free from tuberculosis.
In a few of these, however, the mesenteric glands were likewise affected,
so that some might have been detected from these foci.

Turning to infection, by way of the digestive tract, we may note at
the outset that of the 53 infected animals only one had tuberculous
lesions of the mucous membrane of the small intestine. In this case
(No. 338) tuberculosis had become generalized over the entire lym-
phatic system, the lungs were almost completely converted into tuber-
culous masses and the serous membranes of thorax and abdomen were
studded with them. The animal was very weak and lying down most

of the time shortly before it was killed. Nevertheless, there was no

— ”

ef =

29

macroscopice evidence of generalized tuberculosis, for the parenchyma cf
liver, spleen, and kindneys was free from visible tuberculous lesions.
The intestinal infection consisted of an infiltration of all Peyer’s patches,
followed by marked thickening of the walls and subsequent ulceration.
The borders of the excavated patches were thickened until the latter
assumed a decided boat-shaped outline. The mesenteric glands were
very large and completely caseous.

Infection by way of the intestinal tract was indicated in fourteen cases
by tuberculosis of a smaller or larger number of mesenteric glands.

To these should be added three cases in which only the portal system
was infected and in which the infection probably came from the diges-
tive tract. There were, therefore, in all eighteen cases with tuberculous
lesions, resulting from au entrance of the bacilli by way of the intestines.
The question whether this infection was primary, or secondary to dis-
ease of the lungs is worthy of consideration and may be partially
answered by an examination of the individual cases.

In the severe case with tuberculous ulceration of Peyer’s patches
the tubercle bacilli probably came from the lungs. That they were
discharged in abundance was demonstrated by the condition of the
larynx and trachea. The mucous membrane of this tube was densely
packed with tubercles, so as to form a compact elevated layer. The
tuberele bacilli coughed up from the lungs produced tubereulosis of the
trachea and when swallowed the bacilli attacked the intestinal walls.
Among the remaining seventeen cases there are some (Nos. 307, 335,
J47, 348, 355, and 358) in which the infection must be regarded either
aS independent of or simultaneous with the chest affection, since it
would be impossible to explain how tubercle bacilli could travel from
a closed focus in the bronchial and mediastinal glands to the mesenteric
or the portal glands, and to them only.

There is but one case (No. 535) in which there was intestinal infec-
tion without lung infection.

The cases that still remain are all associated with disease of the lungs
(Nos. 303, 306, 311, 314, 318, 324, 336, 337, 339, and 362). In these the
infection of the mesenteric glands and the liver may have been contem-
poraneous with the lung infection. Of the tubercle bacilli introduced
into the body at the same time some may have found their way into the
digestive tract, others into the lungs. A perusal of the autopsy notes
will show, however, that, at least in some of these cases, the intestinal
infection is more recent and much less pronounced than the lung infee-
tion, and may have been brought about by swallowing tuberculous
matter coughed up from the air tubes.

The infection of the liver or the lymph glands at the hilus, already
mentioned above, was observed in nine cases. In six of these the infec-
tion of the liver was associated with tuberculosis of the mesenteric
glands, and hence it is reasonable to regard them as both originating
in the digestive tract. Of the three cases remaining, two showed tuber-

30

culosis of the glands at the hilus, and in ore the liver contained a large
tuberculous focus. These were probably of intestinal origin, for the
infection of the body as a whole was either very slight (Nos. 307, 335}
or else traceable to pulmonary disease (No. 324).

The infection by way of the lungs was, therefore, much more preva-
lent in this herd than infection by way of the intestines, the ratio being
as 2.6 to 1, even if we regard all the cases of intestinal infection as
primary, which I think no one will concede. In fact, the ratio is prob-
ably nearer 5 to 1.

A point very important from the standpoint of prevention is the con-
dition of the bacilli when entering the body. Primary lung infection
can not take place unless the bacilli are inspired with the air. They
must, therefore, be dried and carried as dust. Hence in 88.6 per cent
of the cases the infection, either as a whole or in part, was caused by
dried bacilli capable of floating in the air.

The udder was found free from tuberculous deposits in all eases. In
one, however (No. 303), there were large caseous foci in the pubic or
udder lymph glands. These are evidence of a former infection of the
udder itself. Taking this and all other cases of equal severity into
consideration I am inclined to look upon this infection as internal in
origin, that is, carried to the udder in the blood from some other focus,
and not as a result of infection from without. There was no sign of
uterine infection in any animal.* In several cases of advanced
tuberculosis of the appendages of uterus (ovaries and Fallopian tubes)
and slight tuberculosis of the uterus itself which have come under my
observation during the past three or four years the infection evidently
traveled from the peritoneum, which was extensively diseased in such
animals.

A summary of the disease in this herd, grouped with regard to the
distribution of the lesions, is presented in the following table:

Total number of animals in the herd examined. 22.5222. 2-2--- =e eee 60
Total number of animals infected (88 per cent). -2--- 22... .--- -- = ee eee ey
Number in which retropharyngeal glands only were affected ............---..:-- 5
Total number in which retropharyngeal glands were affected.......----.-.-...-- 9
Number in which disease of the thoracic organs was detected.....--.........---- 47
Number in which lungs were atfected =. - 22-522 25 anne ase 20
Number in which thoracic glands but not the lungs were diseased. -....-...-..-- 27
Number in which only bronchial glands were affected..-.......-...---.-....... 5
Number in which only mediastinal glands were affected.---....-......--....... b.
Number in which lungs diseased and glands healthy...-.....-...-.------------. ul
Number with exclusively thoracic lesions (air infection) -.....-----....-....-.-- 26
Number in which digestive tract, including head glands, affected-..--.......... 26
Number in which intestinal walls were affected. ...--.....-..-..-. 222 -ce-uscees i!
Number in which mesenteric glands were affected....---.:----.--------.------s 16
Number in which portal glands were affected ...:-...-.-.-------- 225s cceueeeeee 10
Number in which mesenteric and not portal glands affected.-.......-.-....-.--- 10

“ The very advanced case (No, 338) was not examined with reference to this
organ,

al

Number in which portal and not mesenteric glands affected. .............--.---- 4
Number in which parenchyma of liver involved............---.--.----.---.---- 2
Number in which serous membranes affected ..........-...----.----------------- 2
Nommibermewhichudder slandsiattected. 220225222255 2222 slob le eect t 1

SUMMARY OF TUBERCULIN REACTION AND AUTOPSY NOTES.

[The clinical notes and the tuberculin reactions were supplied by Drs. Kilborne and Schroeder.
For the autopsy notes Dr. Smith is responsible. ]

No. 301.—Cow, three-fourths Holstein, 4 years old. Weight, 850 pounds. Calved
summer of 1892; stillgiving milk. Pregnantsince August 21,1892. Condition good.
- February 2, 1893: 9 a. m., first injection, 0.25 cc. tuberculin 8.; 6 to7 p.m., periods
of trembling observed. Feces softened and passed more frequently than usual.
Before injection, minimum temperature, 100.1° (10 a.m.); maximum, 102° (3 p.m.).
After injection, minimum temperature, 101.2° (1 p.m.); maximum reached in twelve
hours, 106.8° (9 p.m.). (For complete record see p. 60.)

March 21, 1893: Midnight, second injection, 0.4 cc. tuberculin K. Before injec-
tion, maximum temperature, 102.7° (4 p.m.);* after injection, reached in sixteen
hours, 106.5° (4 p.m.). (For complete record see p. 69.)

March 24, 1893: Killed for examination.

Autopsy.—Thorax: All the bronchial and posterior mediastinal glands infected.
The disease appears as foci of grayish infiltration in which are delicate networks of
yellowish lines (necrosis). The foci are up to one-half inch in diameter and all
appear to bein about the same stage.

Lungs: Trachea and bronchi free from any visible tuberculous changes.

Abdomen: One mesenteric gland contains a focus about three-eighths inch in
diameter completely transformed into gritty particles.

One gland at the portal fissure contains a tuberculous focus about one- -half inch
in diameter in which the disease process is perhaps somewhat farther advanced than
in the bronchial glands.

No. 302.—Holstein cow, 5 years old. Weight, 850 pounds. Calved July, 1892;
still giving milk. Pregnant since September 30, 1892. Condition good.

February 2, i893: 9 a.m. first injection, 0.25 ce. tuberculin 8.; 5to i0p.m., pulse
fuller and stronger than beforeinjection. Respirationsomewhat accelerated. Feces
softened. Beforeinjection, minimum temperature, 100° (9 a.m.); maximum, 102.29
(4p. m.). After injection, minimum temperature, 101° (1 p. m.); maximum,
reached in ten hours, 107.4° (7 p.m.). (For eomplete record see p. 60.)

March 21, 1893: Midnight, second injection, 0.4 cc. tuberculin K.

March 22: 10 a. m., periods of slight trembling observed. Before injection, maxi-
mum temperature, 102.2° (6 p. m.); after injection, reached in twelve hours, 106.8°
(12a.m.). (For complete record see p. 69.)

March 24, 1893: Killed for examination.

Autopsy.—Thorax: The caudal two-fifths of right caudal lobe of lungs completely
tuberculous. The disease appears. most advanced along the cephalic border of ti.s
involved mass. Here the lung tissue is transformed into soft caseous masses con-
taining some gritty particles, which are over one-half inch in diameter and inclosed
in connective tissue capsules. Toward the caudal extremity of the lobe the foci
are yellowish, necrotic, but not yet broken down, excepting in a few cases. The
bronchus contains a few soft grayish and some caseous tubercles breaking through
the mucosa. There are several cheesy masses lying free on the mucosa. At bifur-
cation there are two irregular spots on the mucosa of trachea one-half inch in
diameter, made up of young and caseous tubercles.

*In giving the hour of minimum and maximum i ipmneeatine sno noe same occurs
more than once the hour of first occurrence is given.

32

A second focus of disease is found embedded in the left caudal lobe. It consists of
a soft caseous mass about one-half inch in diameter without any surrounding recent
infiltration and not in direct relation with any air tube.

The most caudal of the posterior mediastinal glands is from six to ten times the
normal size and contains upwards of fifty tuberculous foci, from one-eighth to one-~
half inch in diameter. They are all necrotic but not yet softened. Only one of
the bronchial glands contains a focus about lire Asbo inch in diameter, which
is in the same stage as those in the mediastinal glands.

No. 803. —Holstein cow, 5 years old. Weight, 950 pounds. Calved July, 1892;
still giving milk. pone since December 2, 1892. Condition good, but has an
occasional hacking cough.

December 7, 1892,6 a. m.: First injection, 0.4 cc. tuberculin K. Before injec-
tion, maximum temperature, 102.5° (8 a. m.); after injection, reached in ten hours,

07° (4p. m.). (For complete record, see p. 59).

February 2, 1893, 9a. m. : Second injection, 0.25 ce. tuberculin 8. From 10 p.
m. February 2 to5 a.m. February 3 the respiration was more or less labored and
the cough more frequent. Feces softened, and passed more frequently than usual.
Before injection, minimum temperature, 998°(10 a. m. dy maximum, 102° (4 p. m.).
After injection, minimum temperature, 100.5° (12 a. m.); maximum, reached in
eleven hours, 105.6° (8p.m.). (For complete Sesri see p. 60),

March 18, 1993: Killed for examination.

Autopsy.—Udder: In one of the lymph glands on the right half of the udder four
tuberculous foci, varying from one-eighth to one-half inch in diameter. The glands
of the left half of the udder contain anumber of tuberculous foci, from one-fourth
to Linch indiameter. All contain a mortar-like substance, with many gritty par-
ticles, and appear tobe of thesameage. The udder itself does notshow any disease.

Thorax: The lungs are more or less affected. In the right there are a few nod-
ules inthe cephalic lobe; in the caudal lebe a mass as large as a hen’s egg, and the
entire caudal half iny “aa In the left lung there is one small nodule in cephalie
lobe, three foci fully one-half inch in diameter in the ventral lobe. The caudal
lobe is affected very much like its corresponding right lobe. ‘The various foci are
situated chiefly along the median dorsal border of the lungs. The contents of the
foci are mainly soft, cheesy in character, the individual masses reaching the size of
a hen’s egg.

Bronchial and posterior mediastinal glands are enlarged and contain caseous foci
one-eighth to one-fourth inch in diameter, embedded in a cousiderable quantity of
hyperplastic tissue. The anterior mediastinals contain a few sinall nodules.

Abdomen: The mesenteric glands are likewise involved. The foci are caseous but
still partially firm in texture, and vary from one-eighth to one-half inch in diame-
ter. Small intestine normal.

The glands at the portal fissure are enlarged and contain caseous nodules.

No. 504.—Holstein cow, 5 years old. Weight, 850 pounds. Calved July, 1892, and
is giving milk. Pregnant since September 19,1892. Condition very good.

December 7, 1892: First injection, 0.4 ce. tuberculin K. Before injection, maxi-
mum temperature, 102.2° (6 p.m.); after injection, 102.69 (6 p.m.). (For complete
record see p. 59.)

February 2,1893,9 a. m.: Second injection, 0.25 ec.tuberculin 8. Before injec-
tion, minimum temperature, 98.6°* (9 a.im.); maximum, 102.39 (4 p.m.). After injee-
tion, minimum temperature, 101.29 (1 p.m.); maximum, 102.6° (6 p.m.). (For coin-
plete record see p. 60.) ;

April 21, 1893: Killed for examination.

Au lapey. —No tuberculosis.

“The low ees morning Pipes in a few cases was probably due to the fact
that the cattle were turned into the yard, where they had access to cold water, just
before the experiment commenced.

\

33

No. 305.—Holstein cow,5 years old. Weight,1,000 pounds. Calved October 23,
1892, and is giving milk. Pregnant. Condition gvod.

February 2, 1893, 9 a.m.: First injection, 0.25 ce. tuberculin §. Before injection,
minimum temperature, 99.4° (9 a. m.) maximum; 101.8° (3 p.m.) ~ After injection,
minimum temperature, 100.7° (1 p.m.); maximum, 102.8° (5 p.m.). (Hor complete
record see p. 61. )

March 21, 1893, midnight: Second injection, 0.4 cc.tuberculin K. Before injec-
tion, maximum temperature, 102° (6 p.m.); after injection, reached in sixteen hours,
108° (4 p.m.).. (For complete record see p. 69.)

May 25, 1893, midnight: Third injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 101.6° (6 p.m.); after injection, reached in seventeen hours,
103.6° (5 p.m.). (For complete record see p. 74.)

June 29, 1893: Killed for examination.

Autopsy.—No traces of tuberculosis discoverable.

No. 306.—Cow, fifteen-sixteenths Holstein, 6 years old. Weight, 950 pounds. Calved
summer of 1892; is giving milk. Pregnant since November 3, 1892.

December 7, 1893, 6a.m.: First injection. 0.4 cc. tuberculin K. Before injection,
maximum temperature, 102.6° (8 a.m.); after injection, reached in fourteen hours,
106° (8p. m.). (For complete record see p. 59.)

February 2, 1893, 9 a.m.: Second injection, 0.25 cc.tuberculin S. Before injec-
tion, minimum temperature, 99.6° (10 a.m.); maximum,102.2° (8a.m.). After injec-
tion, minimum temperature, 100.4° (1 p.m.); maximum, reached in thirteen hours,
106.4° (10 p.m.). (For complete record see p. 61.)

March 21, 1893: Killed for examination.

Autopsy.— Thorax: In the caudal extremity of the left caudal lobe, near the median
border and not directly associated with any bronchus, is a tuberculous mass about
14 inches in diameter. This mass consists of an aggregation of soft cheesy
masses, each provided with a connective tissue capsule, and about one-fourth
inch in diameter. In the bronchus of this lobe are three or four tuberculous excres-
cenees of the mucosa about three-sixteenths inch in diameter. In the most caudal
of the posterior mediastinal glands, which is 5 inches long and 14 inches wide at

widest portion, there are a considerable number of tuberculous foci varying from.

one-sixteenth to one-half inch in diameter. Several are almost entirely calcareous.
The remainder are in a stage indicative of rapid hyperplasia and necrosis. In
another gland of the same series near the bifurcation of the trachea, as well as
in one of the bronchial glands, there are three or four similar foci.

Abdomen : In many of the mesenteric glands there are minute tubercles with case-
ous centers, from one to four in a gland, mainly in the cortex. Scattered through
the liver tissue chiefly under capsule are small yellowish nodules about one-eighth
inch in diameter, probably of parasitic origin.

No. 307.—Cow, half Holstein, 4 years old. Weight, 8)0 pounds. Calved October
14, 1892, and is giving milk. Pregnant. Condition good.

February 2, 1893: 9 a. m., first injection, 0.25 cc. tuberculin 8. ; 8 to 9p. m., TST BOL
trembling. Respiration Fae or less labored. Feces much soatonienl <

Before injection, minimum temperature, 100.8° (4 a. m.) ; maximum, 102.4° (4 p.

m.). After injection, minimum temperature, 101° (1 p. m.) ; maximum, reached in
twelve hours, 107.69 (9 p.m.). (For complete record see p. 61.)

March 21, 1893: Midnight, second injection, 0.5 cc. tuberculin K.

“ March 22: 7to 8 p.m., trembling, which becomes very marked about 8 p. m., and
then gradually wears off. Feces softened. Before injection, maximum temperature
103° (4 p. m.) ; after injection, reached in fourteen hours, 106.39 (2p. m.). For
complete record see p. 69.)

April 4, 1893 : Killed for examination.

dutopsy.—Thorax : In the most caudal of the posterior mediastinal glands there are
about five tuberculous foci ranging from one-fourth to one-half inch in diameter,

2891—No. 7

a
oO

o4

They consist of grayish translucent tissue in which is disseminated a network of
yellowish lines. One contains a minute calcareous nucleus.

Abdomen: In some mesenteric glands are worm tubercles containing an earth-
colored mass.

One of the portal glands contains three tuberculous foci of same character as those
in mediastinal gland. The contents are dry and in part calcareous.

No. 308.—Holstein heifer, 2 years old. Weight, 500 pounds. Has never been
served by bull. Condition fairly good.

February 2, 1893: 9a. m., first injection, 0.25 ce. tuberculin 8. Before injection,
minimum temperature 101° (1 p. m.); maximum, 102.3° (4 p.m.). After injection,
minimum temperature 101.1° (12 a. m.); maximum, reached in ten hours, 104.6°
(7 p.m.). (For complete record see p. 61.)

Mareh 21, 1893: Midnight, second injection, 0.35 ec. tuberculin K. Before injec-
tion, maximum temperature, 102.2° (7 p. m.), after injection, reached in nine hours,
103° (9a. m.). (For complete record see p. 69.)

May 25, 1893: Midnight, third injection, 0.2 cc. tuberculin 8S. Before injection,
maximum temperature 102.4° (6 p. m.); after injection, reached in eighteen hours,
103° (6 p.m.). (For complete record see p. 74.)

June 5, 1893: Killed for examination.

Autopsy.—The only focus of tuberculosis in this animal is contained in a mediasti-
nal lymphatic gland situated on the dorsal aspect of the trachea at the branching
off of the bronchus going to the right cephalic lobe of the lungs. The focus consists
of a soft, cheesy, partly gritty mass about one-half inch in diameter. The surround-
ing tissue is not infiltrated. the gland only slightly enlarged.

No. 309.—Heifer, a mixture of deragy and Holstein, 2 years old. Weight, 500
pounds. Pregnant since January 22, 1893. Condition fairly good.

February 2, 1893: 9 a. m., first injection, 0.25 ec. tuberculin 8.; 6 to 8 p. m.,
marked trembling, especially violent about 7 p.m. Before injection, minimum
temperature 100° (10 a, m.); maximum, 102.4° (5 p.m.). After injection, minimum
temperature 101° (12 a.m.), maximum, reached in eleven hours, 104.8° (8 p. m.).
(For complete recoril see p. 62.)

March 21, 1893: Midnight, second injection, 0.35 ce. tuberculin K. Before injec-
tion, maximum temperature 102.4° (4 p. m.); after injection reached in sixteen
hours, 104° (4 p. n.). (For complete record see p. 69.)

May 25, 1893: Midnight, third injection, 0.2 cc, tuberculin S. Before injection,
maximum temperature 102° (8 a. m.); after injection, reached in eighteen hours,
102.6° (6 p..m.). (For complete record see p, 74.)

June 5, 1893: Killed for examination.

Autopey.—Left retropharyngeal gland enlarged to twice its normal size. On sec-
tion the parenchyma appears of a more or Jess uniformly yellowish gray color, and
in it are imbedded a considerable number of calcareous particles one-twelfth to one-

eighth inch in diameter. The corresponding right gland is larger than normal, ee
on distinct tubercular changes are detected in it.

No. 310.—Jersey heifer, 18 months old. Weight, 350 pounds. Has never been
served by bull. Condition fairly good.

February 2, 1893: 9 a. m., first injection, 0.125 cc. tuberculin S. Before injec-
tion, minimum temperature 100° (9 a. m.); maximum, 102.8° (8 a.m.). After
injection, minimum temperature, 102° (12a. m.); maximum, reached in nine hours,
105.8° (6p. m.). (For complete record see p. 62.)

March 21, 1893: Midnight, second injection, 0.2 cc. tuberculin K. Before injec-
tion, maximum temperature 102.6° (4 p. m.); after injection, reached in sixteen
hours, 106° (4 p. m.). (For complete record see p. 69.)

April 4, 1893: Killed for examination.

35

Autopsy.—Thorax: In the most caudal of the posterior mediastinal glands are
two tuberculous centers. One is one-half to three-fourths inch in diameter and
made up of irregular gritty particles up to one-eighth inch in diameter, embedded
in a translucent grayish matrix. The second focus is likewise calcareous. Between
the two are pale yellowish necrotic foci about one-eighth inch in diameter, some
with a central calcareous particle. —

In the gland situated dorsally on the trachea at the root of the bronchus going to
right cephalic lobe there are a considerable number of foci varying from one-eighth
to one-fourth inch in diameter, the larger calcareous.

No. 311.—Cow, half Holstein, 7 years old. Weight, 850 pounds. Is giving milk.
Pregnant since August 24, 1892. .

December 7, 1892: 6 a. m., first injection, 0.4 cc. tuberculin K. Before injection,
maximum temperature 102.5° (8 a.m.); after injection, reached in twelve hours,
106° (6p. m.). (For complete record see p. 59.)

March 16, 1893: 9 a. m., second injection, 0.25 cc. tuberculin S.; 9 to 10 p. m.,
slightly trembling. Before injection, minimum temperature 100° (9 a. m.); maxi-
mum, 102.4° (5p.m.). After injection, minimum temperature, 100.2° (11 a. m.);
maximum, reached in fourteen hours, 106.6° (11 p.m.). (For complete record see
p. 62.)

March 21, 1893: Killed for examination.

Autopsy.—Thorax: On caudal border of right cephalic lobe, extending inward from
free margin for about 14 inches, is a tuberculous focus 1 inch thick, visible on both
lung surfaces and projecting above both surfaces in the collapsed condition of the
lung. This focus is situated between the two main branches of the bronchus sup-
plying the lobe. A smaller branch may be traced into it. It consists of a number
of small foci up to one-half inch in diameter, made up of soft putty-like cheese,
with a central, slightly firmer core, the whole imbedded in fairly firm, not very
abundant, connective tissue. Some of the foci are not yet broken down and consist
of a yellowish, necrotic center and a grayish, translucent periphery. No calcification
is observed. A small segment of the lung tissue on median border of this focus is in
a state of tuberculous infiltration of more recent date. The bronchial tubes of this
lobe are free from abnormal contents. The mediastinal gland, situated dorsally near
right supernumerary bronchus, contains one large focus over one-half inch in diam-
eter, made up of a yellowish, rather soft, cheesy mass. A second focus in the same
gland is nearly as large as the first, and contains, in addition to dry, yellowish,
cheesy material, a calcareous mass, one-eighth inch in diameter. Besides these, the
more or less hyperplastic gland substance contains six or more small necrotic foci.

Abdomen: In the mesenteric glands a few small caseous tubercles are present.

No. 312.—Holstein cow, 6 years old. Weight, 800 pounds. Is giving milk. Preg-
nant since January 2, 1893.

March 16, 1893: 9 a. m., first injection, 0.25 cc. tuberculin S.; 4:30 p. m., slight
trembling, which becomes so violent by 5:30 p. m. that it interferes with counting the
pulse. This trembling does not cease entirely until 12 p.m. at 8 p.m. feces con-
siderably softened, each passage followed by straining. Very little of the usual
allowance of hay eaten during the evening. Before injection, minimum temperature,
99.8° (10 2.m.); maximum, 103° (4 p.m.). After injection, minimum temperature,
100.4° (11 a.m.); maximum reached in nine hours, 105.2° (6p.m.). (For complete
record see p. 62.)

March 27, 1893, midnight: Second injection, 0.4 cc. tuberculin K. Before injection,
maximum temperature. 102° (4 p. m.); after injection, reached in eleven hours,
104.8° (11 a.m.). (For complete record see p. 69.)

April 28, 1893: Killed for examination.

Autopsy.—Thorax: In the cephalic lobe of the right lung on the median border is
a small focus of disease about 1 inch in diameter. A small bronchus leads to it and

36

near the focus its mucosa is sprinkled with grayish tubercles. The affected lung
tissue contains much connective tissue inclosing calcareous foci. ‘There are very few
apparently fresh tubercles.

The posterior mediastinal glands are all affected. The most caudal of the series is
considerably enlarged, and contains five dry, largely calcareous foci up to one-half
inch in diameter. There is, in addition, in one end of the gland a considerable
development of fresh, grayish tubercles; the same is true of the opposite end of the
gland. The second gland of the series contains a small, caleareous focus about one-
eighth inch in diameter. The third gland, about 1 inch in diameter, contains three
or more similar foci. Its exterior is more or less nodulated and retracted. The
fourth gland contains two similar foci and some recent infiltration. The fifth is in
the same condition as the fourth. The sixth gland contains two similar foci. These
glands are moderately enlarged. The bronchial gland, situated on the root of the
left bronchus is about 1} inches in diameter, of slightly irregular outline, and con-
tains in its center a partly calcareous focus one-balf inch in diameter and several
small foci of more recent origin. The other bronchial glands are also involved.

Abdomen: On the peritoneal aspect of the diaphragm and attached to the reticu-
lum is a tumor about 14 inches in diameter, containing a small quantity of creamy
pus within a dense connective tissue capsule, and surrounded by a considerable quan-
tity of gelatinous-looking connective tissue (traumatism due to foreign body from
reticulum),

No. 313.—Cow, fifteen-sixteenths Holstein, 6 yearsold. Is givingmilk. Pregnant
since November 25, 1892.

March 16, 1893: 9 a. m., first injection, 0.25 cc. tuberculin 8. 9 p. m., periods
of slight trembling observed. 10:20 p. m., the trembling is very marked, but ceases
by ll p.m. The long hay not eaten this evening.

March 17, 2 a.m.: Several periods of slight trembling. Before injection, mininum
temperature, 99.4° (10 a.m.); maximum, 102.39 (4 p.m.) After injection, minimum
temperature, 100.6° (11a. m.); maximum, reached in fourteen hours, 106.6° (11 p. m.).
(For complete record see p. 63.)

March 27, 1893, midnight: Second injection, 0.4 cc. tuberculin K. Before injec-
tion, maximum temperature, 102.4° (4 p. m.); after injection, reached in thirteen
hours, 104.4° (1 p.m.). (For complete record see p. 69.) é

April 7, 1893: Killed for examination.

Autopsy.—The only tuberculous lesions found in this animal are two soft masses,
about one-half inch in diameter, in the bronchial gland at the root of the left
bronchus.

With a small quantity of this caseous material 2 guinea-pigs were inoculated sub-
cutaneously.

One killed two and one-half months after inoculation showed an ulcer at the place
of inoculation and the neighboring lymphatics caseous. The spleen and liver con-
tained masses of tubercles, the retrogastric and the bronchial glands were enlarged
and necrotic.

The second, killed in a dying condition three months after inoculation, showed
very extensive tuberculous changes in liver, spleen, and lungs.

Tn the cow there is considerable enlargement of all thoracic lymph glands, prob-
ably due to traumatic pneumonia, resulting from the passage of a foreign body from
the reticulum through the diaphragm.

On the serous aspect of the reticulum there is a patch of gelatinous tissue, about
6 by 8 inches square and from one-half to 1 inch thick, attaching it to diaphragm.
The nearest lymph glands of the paunch are enlarged and contain creamy pus. In
the thorax the right ventral lobe is enlarged, very firm, and adherent to ribs and
diaphragm. A tubular connective tissue passage extends from diaphragm into the
affected lobe. The phrenic end is now closed. When this passage was cut a milky
pus of penetrating but not offensive odor flowed out from a cavity in the affected

37

lung tissue about as large as a hen’s egg. The firmness of the surrounding lung
tissue is due mainiy to inflammatory thickening of the interlobular and subpleural
tissue. This is most pronounced on the periphery of the cavity, where it forms a
thick capsule and decreases gradually from it. The cut surface of the lung tissue
presents a marbled appearance in consequence of this condition.

No. 314.—Jersey cow, 6 years old. Weight, 850 pounds. Is giving miJk. Preg-
nant since September 7, 1892.

December 7, 1892, 6 a.m.: First injection, 0.4 cc.tuberculin K. Before injection,
maximum temperature, 102.5° (4 p. m.); after injection, reached in fourteen hours,
106° (8p. m.). (For complete record see p. 59.)

March 16, 1893: 9 a. m., second injection, 0.25 ce. tuberculin S. 10:30 p. m., res-
piration quite short and quick. Very little of the long hay eaten. Feces much
softened. Before injection, minimum temperature 99° (9 a.m.); maximum, 102.6°
(8 a.m.). After injection, minimum temperature, 100.89 (12 a.m.); maximum,
reached in twelve hours, 107° (9 p.m.). (For complete record see p. 63.)

March 18, 1893: Killed for examination.

Autopsy.—Thorax: In the caudal lobe of right lung a triangular mass of tuber-
culous infiltration about 2 inches in diameter, situated on the cephalic border.

Costal pleura of the left side extending backward from the eighth rib is beset with
a small number of isolated and confluent, in part pediceled, tubercles.

In the cephalic lobe of the left lung two tuberculous foci, one about one-half inch
in diameter, the other consisting of two nodules, each about one-fourth inch in
diameter.

In the caudal lobe of the left lung, near the center, a tuberculous mass of trian-
gular outline, about 4 inches across and 24 inches thick, tapering toward the lateral
border of the lobe.

The tuberculous foci consist of round, encapsuled masses from three-eighths to one-
half inch in diameter. The contents, with some exceptions, are still quite firm, not
easily disintegrated. Calcareous particles not present. They are surrounded by
regions of hyperemic lung tissue infiltrated with small, partly caseous tubercles or
else with lung tissue of nearly normal appearance containing many miliary tubercles.
‘he bronchi leading to the affected regions contain more or Jess viscid mucus. One
leading to a focus more or less softened and broken down contains tubercles on the
mucosa.

Bronchial gland at root of left bronchus about 14 inches in diameter. Contents
putty-like, inclosed in a dense capsule in which are embedded small caseous tuber-
cles.

The large posterior mediastinal gland, 4 by 2 by 14 inches. Parenchyma caseous,
as with bronchial gland.

Abdomen: One of portal glands contains a small caseous focus about one-eighth
inch in diameter.

A few mesenteric glands contain small, in part caseous, tubercles. Glands not
enlarged.

No. 315.—Cow, half Holstein, 6 years old. Weight, 850 pounds. Calved December
2,1892; isgiving milk. Has not beenserved by bull since calving. Condition good.

Marck 16, 1893: 9 a. m., first injection, 0.25cc. tuberculin 8S. 8p. m., occasional
slight, sharp cough. 9p.m., pulse quite strong, but the beats are short and sharp.
Before injection, minimum temperature, 98.6° (9 a.m.); maximum, 102.4° (5 p.m.).
After injection, minimum temperature, 100.8° (12 a.m.); maximum, reached in twelve
hours, 106.8° (9 p.m.). (For complete record see p. 63.) :

March 27, 1893, midnight: Second injection, 0.4 cc. tuberculin K. Before injection
maximum temperature, 102.2° (4 p. m.), after injection, reached in thirteen hours,
105.2° (1p.m.). (For complete record see p. 70.)

38

May 25, 1893, midnight: Third injection, 0.5 ce. tuberculin 8. Before injection,
maximum temperature 103.1° (8 p. m.) ; after injection, reached in twelve hours, 105.3°
(12a.m.). (For complete record see p. —.)

June 1, 1893: Killed for examination.

Autopsy.—Right parotid lymph gland contains several tuberculous foci with cheesy
contents embedded in a mass of firm connective tissue. These foci are each about
one-fourth inch in diameter. Both retro-pharyngeal glands are enlarged, about2 by
1 by $inch in size, quite nodular in form. On section both glands are almost com-
pletely converted into a mass of confluent tuberculous foci. Each focus is about
one-fourth inch in diameter, with soft center of putty-like consistency and a rather
firm connective tissue capsule. The disease in both glands is equally extensive and
of about the same age. Both tonsils are enlarged and contain tuberculous foci.
These appear as slightly elevated patches on the cut surface, firmer than the gland
tissue and showing within their mass a network of small yellowish (necrotic) lines.

No. 3816.—Jersey cow, 6 years old. Is giving milk. Pregnant since September
25, 1892. :

March 16, 1893, 9 a. m.: First injection, 0.25 cc. tuberculin S. Before injection,
minimum temperature, 100.8° (12 p.m.); maximum, 102.6° (4p.m.). After injection,
minimum temperature, 100.6° (11 a.m.); maximum, reached in fourteen hours, 106.2°
(11 p.m.). (For complete record see p. 63.)

March 27, 1893, midnight: Second injection, 0.4 cc. tuberculin K.

March 28,9 to 10 a.m.: Stands with back very much arched and trembles quite
violently. Before injection, maximum temperature, 103.1° (4 p.m.); after injection,
reached in twelve hours, 106° (12 a.m.) (For complete record see p. 70.)

April 7, 1893: Killed for examination.

Autopsy.—Thorax: A considerable number of tuberculous nodules in the large pos-
terior mediastinal gland, and in the mediastinal near arch of aorta. About a dozen
yellowish nodules, one-sixteenth inch in diameter, in the bronchial gland at root of
left bronchus.

Abdomen: One small, doubtful nodule in a mesenteric gland.

No. 317.—Heifer, fifteen-sixteenths Holstein, 3 years old. Weight, 500 pounds.
Reported to have been served by bull every three weeks during the past six months
without becoming pregnant.

March 16, 1893: 9a.m., first injection, 0.25 cc. tuberculin 8. 8 p.m., trembling,
which becomes very violent at 9 p.m., and ceases about 11 p.m. Before injection,
minimum temperature, 100° (10 a.m.); maximum, 103° (5 p.m.). After injection,
minimum temperature, 101.4° (12 a. m.); maximum, reached in eighteen hours,
105.8° (8 p.m.). (For complete record see p. 64.)

March 27, 1893, midnight: Second injection, 0.3 ce. tuberculin K. Before injec-
tion, maximum temperature, 102.8° (5 p.m.); after injection, 102.7° (1 p.m.). (For
complete record see p. 70.)

April 21, 1893: Killed for examination.

Autopsy.—The only lesion of tuberculous nature in this animal is found in the
bronchial gland at the root of the left bronchus. This gland is enlarged and con-
tains about six foci, some of which are about one-half inch in diameter. All are
caseous and a few contain a considerable number of calcareous particles.

In both kidneys the external surface is sprinkled over with small grayish spots up
to one-twelfth inch in diameter. These correspond to streaks of the same color pen-
etrating the cortex radially for a depth of one-eighteenth to one-sixth inch. Organs
otherwise normal.

No. 318.—Heifer, fifteen-sixteenths Holstein, 1 year old. Weight, 500 pounds.
March 16, 1893: 9 a. m., first injection, 0.25 cc. tuberculin 8S. 6:30 to 7 p. m., occa-
sional periods of trembling. Hay only partly eaten. Before injection, minimum

v4 be
ae

39

temperature, 98.6° (10 a. m.); maximum, 103.2° (8a.m.). After injection, minimum
temperature 101.4° (12 a. m.); maximum, reached in ten hours, 107.4°(7p.m.). (For
complete record see p. 64.)

March 27, 1893: The temperature was taken for another injection, but owing to a
rise from 102° at 8 p. m. to 105° at 11 p.m., due to an unknown cause, the injection
was postponed. ;

March 28: The temperature was 104.8° at 7a. m., 103.5° at 8a. m., and 102° at 9
a.m., after which it continued normal. Excepting the elevation in temperature the
animal was apparently in good health. (See also No. 357.)

April 12, 1893, midnight :-Second injection, 0.2 ce. tuberculin 8.

April 13, 9:20 a. m.: Periods of slight trembling. Before injection, maximum
temperature, 103.4° (5 p.m.); after injection, reached in seventeen hours, 107.2° (5
p.m.). (For complete record see p. 70.)

April 14, 1893: Killed for examination.

Autopsy.—Thorax: In the right caudal lobe a tuberculous region about 4 inches
long and 2 inches in diameter. This consists almost entirely of soft caseous masses
embedded in a conglomerate of rather thin-walled, connective-tissue capsules.
_ Only on the periphery the lung tissue is stillrecognizableas such. The surrounding
lung tissue is free from recent infiltration. Trachea and bronchus of affected lobe
free from tuberculous changes. Some cheesy masses found, in which tubercle
bacilli were searched for with negative result. Posterior mediastinal glands consoli-
dated into a mass 8 to 10 inches long and 3 inches in diameter at the center. This
glandular mass is found on section to be grayish yellow in color and penetrated by
a dense network of yellowish lines. The bronchial glands are free with one excep-
tion. This contains a single yellowish, caseous focus.

Abdomen: One of the mesenteric glands contains a single recent focus about one-
eighth inch in diameter.

In one of the portal glands two gritty foci one-eighth and one-fourth inch in diam-
eter.

No. 319.—Heifer, fifteen-sixteenths Holstein, 1 year old. Weight, 500 pounds.
Has never been served by bull.

March 16, 1893, 9a. m.: Firstinjection, 0.25 ¢c.tuberculinS. Before injection, mini-
mum temperature, 99° (11 a. m.); maximum, 103.3° (5p.m.). After injection, mini-
mum temperature 100.89 (12 a. m.); maximum, 102.8° (9 p. m.). (For complete
record see p. 64.)

March 27, 1893, midnight: Second injection, 0.2 cc. tuberculin K. Before injec-
tion, maximum temperature, 103° (6 p. m.); after injection, 103° (7 p. m.). @For
complete record see p. 70.)

May 25, 1893, midnight: Third injection, 0.2 cc. tuberculin S. Before injection,
maximum temperature, 103.6° (6 p.m.); after injection, 102.99 (6 p.m.). (For com-
plete record see p. 74.)

July 3, 1893: Killed for examination.

Autopsy.—In the left bronchial gland there are three small tuberculous foci largely
calcareous. Recent surrounding infiltration absent. Slight adhesions of cephalic
end of liver to surrounding structures.

No. 520.—Heifer, mixture of Jersey and Holstein, 2} years old. Weight, 700
pounds. Pregnant since February 15, 1893. Previous to this she had been served
by the bull every three weeks for five or six months without conceiving.

Mareh 16, 1893, 9a.m.: First injection, 0.25 ee. tuberculin S. Before injection,
minimum temperature, 98.8° (9 a.m.); maximum, 102.6° (5 p.m.); after injection,
minimum temperature, 99.8° (12 a.m.); maximum, reached in fourteen hours, 104.2°
(11 p.m.). (For complete record see p. 64.)

March 27, 1893. midnight: Second injection, 0.3 ce. tuberculin K. Before injection,
maximum temperature, 102.8° (4 p.m.); after injection, 102.69 (1 p.m.). (For com-
plete record see p. 70.)

AQ

May 25, 1893, midnight: Third injection. 0.2 cc. tuberculin 8S. Before injection,
maximum temperature, 102° (6 p.m.); after injection, reached in seventeen hours,
103.4° (5 p.m.). (For complete record see p. 71.)

June 15, 1893: Killed for examination.

Autopsy negative.

No. 321.—Jersey heifer, 3 years old. Pregnant sinve September 19, 1892.

March 16, 1893, 9a. m.: First injection, 0.25 ec. tuberculin 8. Before injection,
minimum temperature, 100.4° (12 a. m.); maximum, 102.2° (6 p. m.). After injec-
tion, minimum temperature, 100.8° (1 p. m.); maximum, reached in fourteen hours,
103.4° (11 p.m.). (For complete record sce p. 65.)

March 27, 1893, midnight: Second injection, 0.3 cc. tuberculin K. Before injec-
tion, maximum temperature, 102.5° (6p. m.); after injection, 102° (5 p.m.). (For
complete record see p. 70.)

May 25, 1893, midnight: Third injection, 0.25 cc. tuberculin S. Before injection,
maximum temperature, 102° (6 p. m.); after injection, reached in eighteen hours,
102.7° (6p. m.). (For complete record see p. 74.)

June 29, 1893: Killed for examination.

Autopsy.—Traces of tuberculosis not discoverable. Slight adhesions of cephalic —

end of liver to diaphragm. In this region on the free border a yellowish mass of
liver tissue about one-half inch in diameter. The color is due to more or less com-
plete fatty metamorphosis of the liver cells.

No. 322.— Jersey heifer, 1 year old. Weight, 450 pounds. Has never been served
by bull.

March 16, 1893, 9 a. m.: First injection, 0.2 cc. tuberculin 8. Before injection,
minimum temperature, 99.6° (9a. m.); maximum, 102.5° (9p. m.). After injection,
minimum temperature, 99° (12 a. m.); maximum, reached in fourteen hours, 103° (11
p.m.). (For complete record see p. 65.)

March 27, 1893, midnight: Second injection, 0.2 cc. tuberenlin K. Before injection,
maximum temperature, 102.8° (5 p.m.); after injection, reached in thirteen hours,
104.2° (1 p.m.). (For complete record see p. 70.)

May 25, 1893, midnight: Third injection, 0.125 ce. tuberculin 8. Before injection,
maximum temperature, 102.2 (6 p. m.); after injection, 102.8° (5 p.m.). (For com-
plete record see p. 74.)

July 3, 1893: Killed for examination.

Autopsy.—In the large mediastinal gland thereis one tuberculous focus situated
near the cephalic end of the gland. It is about one-half inch in diameter and almost
completely calcareous. The surrounding tissue is free from recent infiltration.

No. 323.—Heifer, half Holstein, 24 years old. Weight, 750 pounds. Pregnant
since September 26, 1892.

March 16, 1893, 9 a. m.: First injection, 0.25 cc. tuberculin 8. Before injection,
minimum temperature, 99.7° (9 a.m.); maximum, 103.5° (5 p. m.); after injection,
minimum temperature, 100.4° (11 a. m.); maximum, reached in fourteen hours,
106.4° (11 p.m.). (For complete record see p. 65. )

March 27, 1893, midnight: Second injection, 0.3 ec. tuberculin K. Before injee-
tion, maximum temperature, 103.4° (5 p. m.); after injection, reached in thirteen
hours, 105.2° (1 p.m.). For complete record see p. 70.)

April 12, 1893: Killed for examination.

Autopsy.—In this animal the thoracic lymphatics only are involved. One ‘bron-
chial gland measures 2 by 1 inch and is completely converted into a soft caseous
mass. Similarly, three out of four of the chain of posterior mediastinal glands are
as large hens’ eggs and completely caseous. Calcification absent.

No. 524.—Heifer, fifteen-sixteenths Holstein, 3 years old. Weight, 800 pounds
Pregnant since June 16, 1892.

Al

March 16, 1893, 9 a.m.: First injection, 0.25 cc. tuberculin S. Has not eaten any-
thing during the evening or night. Before injection, minimum temperature, 100.5°
(10 a.m.); maximum, 104° (5 p. m.); after injection. minimum temperature, 102.5°
- (12 a. m.); maximum, reached in eighteen hours, 105,8° (3 a. m.). (For complete
record see p. 65.)

March 17: Gave birth to a dead calf, followed by partial retention of the after-
birth.

May 27, 1893, midnight: Second injection, 0.5 ce. tuberculin K.

March 28,7 to 8a.m.: Periods of marked trembling. Before injection, maximum
temperature, 102.8° (5 p. m).; after injection, reached in ten hours, 107° (10 a.m.).
(For complete record see p. 70.)

April 12, 1893: Killed for examination.

Autopsy.—Thorax: The cephalic lobe of the right lung (cephalic half) is almost
entirely involved in tuberculosis. Only a little tissue at the root of ‘the bronchus
and a few areas of the tip still air-containing. The lesion is an intermingling of
- soft caseous foci with surrounding, more recently infiltrated, lung tissue. The lobe
appears as if made up of lumps of various sizes, owing to its collapsed state and the
large size of the tuberculous masses. The bronchial mucosa is beset with a layer
of recent tubercle eruptions near its root, and farther along yellowish flakes are
found mingled with mucus. :

The bronchial glands are all enlarged, the infiltrated parenchyma more or less
caseous and containing gritty particles. One of these is as large as a goose egg and
contains a number of rather small cheesy nodules.

The posterior mediastinal glands likewise contain caseous foci. The process
appears less extensive here than in the bronchial.

Abdomen: One of the portal glands contains a tuberculous mass about one-half
inch in diameter. This is still firm, yellowish, necrotic, and is surrounded by a thick
capsule. The center contains calcareous particles.

On the convex surface of the liver isa flattish tuberculous mass about three-fourths
inch square, elevated above the liver surface about one-eighth inch. On section it
is found one-half inch thick, dipping beneath the surface of the liver; the center soft,
caseous; the periphery firm, grayish translucent.

No. 325.—Grade Holstein cow, 6 years old. Weight, 850 pounds. Calved March
1, 1893, and has not been served by bull since; is giving milk.

March 21, 1893, midnight: First injection, 0.4° ecc.tuberculin K. Before injection,
maximum temperature, 102° (7 p.m.); after injection, 102° (5 p.1u.). (For complete
record see p. 66.)

May 25, 1893, midnight: Second injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature, 102.8° (6 p.m.); after injection, 103° (5 p.m.). (For com-
plete record see p. 70.)

Not killed.

No. 326.—Grade Holstein cow, 6 years old. Weight, 900 pounds. Calved Febru-
ary 14, 1893, and has not been served by bull since; is giving milk.

March 21, 1893, midnight: First injection, 0.4 ec. tuberculin K. Before injection,
maximum temperature, 102.2° (8 a. m.); after injection, 102.8° (4p. m.). (For com-
plete record see p. 66.) 5

May 25, 1893, midnight: Second injection, 0.25 ce. tuberculin S. Before injection,
maximum temperature, 103° (8 p. m.); after injection, 103.4° (3 p. m.). (For com-
plete record see p. 70.)

Not killed.

No. 327.—Cow, 7 years old. Weight, 950 pounds. Calved during spring of 1892
and is still giving milk. Supposed to be pregnant since December 9, 1892.
March 21, 1893, midnight: First injection, 0.4 ce. tuberculin K.

42 :

March 22, 9 a. m.: Feces semifluid, very much thinner than usual. Before injec-
tion, maximum temperature, 103.29 (8 a. m.); after injection, 103.4° (4 p.m.). (For
complete record see p. 66.)

May 25, 1893, midnight: Second injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 102° (4 p. m.); after injection, reached in fourteen hours,
103.6° (2 p.m.). (Forcomplete record see p. 71.)

Not killed.

No. 328.—Cow, fifteen-sixteenths Holstein, 4 years old. Weight, 900 pounds.
Calved December 29, 1892, and is giving milk. Pregnant.

March 21, 1893, midnight: First injection, 0.4 ec. tuberculin K.

March 22, 9:30 to 10a. m.: Occasional periods of slight trembling. Before injee-
tion, maximum temperature, 102° (7p. m.); after injection, reached in twelve hours,
104.2° (12 a.m.). (For complete record see p. 66.)

April 12, 1893, midnight: Second injection, 0.25 cc. tuberculin 8. Before injec-
tion, maximum temperature, 102.7° (4 p. m.); after injection, reached in sixteen
hours, 105.49 (4 p.m.). (For complete record see p. 71.)

May 12, 1893: Killed for examination.

Autopsy.—In one tonsil an abscess about one-half inch in diameter, the contained
pus like starch paste in appearance.

The tuberculous lesions were limited to the large posterior mediastinal gland.
This is 5 by 4 by 14 inches in size. Near one end there are 5 dry, mortar-like
masses one-fourth to one-half inch in size inclosed in thin-walied capsules. No
recent infiltration in the surrounding gland tissue.

-

No. 329.—Cow, fifteen-sixteenths Holstein, 3 years old. Weight, 700 pounds.
Calved February 1, 1893, and has not been served by the bull since; is giving milk.

March 21, 1893, midnight: First injection, 0.4 ce. tuberculin K. Before injection,
maximum temperature, 103° (6 p.m. ); after injection, reached in nine hours, 107.5°
(9a.m.). (For complete record see p. 66. )

April 12, 1893, midnight: Second injection, 0.25 ce. tuberculin 8. Before injec-
tion, maximum temperature 103.4° (4 p.m.); after injection, reached in ten hours,
105.8° (10 a.m.) (For complete record see p. 71.)

April 28, 1893: Killed for examination.

Autopsy.—In this animal the tuberculous lesions are limited to the retropharyn-
geal glands.

The right is as large as a small fist. The parenchyma has undergone difiuse
necrosis. In the external layer of gland tissue are embedded a number of minute
caseous tubercles.

The other gland is 4 by 1by 1} inches in size. It feels as if made up of a large
number of lumps. On section the foci are caseous and embedded in more or less
connective tissue. ‘There is also some diffuse necrosis of the parenchyma.

No. 330.—Cow, 12 years old. Weight, 900 pounds. Calved October 14, 1892, and
has not been served by bull since; is giving milk.

March 21, 1893, midnight: First injection, 0.4 ce. tuberculin K.

March 22, 9:50 to 10:30 a. m.: Very marked trembling. Feces somewhat softened
and passed more frequently than usual. Before injection, maximum temperature,
102.2° (7 p. m.); after injection, reached in twelve hours, 105.8° (12 a.m.), (For
complete record see p. 66.)

April 12, 1895, midnight: Second injection, 0.25 ec. tubereulin §S.

April 13, 8:40 a. m.: Frequent periods of marked trembling. Before injection,
maximum temperature, 102° (8 a. m.); after injection, reached in eleven hours, 105,2°
(lia. m.). (For complete record see p. 71.)

April 25, 1898: Killed for examination.

Autopsy.—The only tuberculous lesion discoverable in this case was found in the
gland at the root of the left bronchus, as a small yellowish focus about one-eighth

43

inch in diameter. In sections of hardened tissue it appears separated from the
remainder of the gland by a thin connective tissue capsule. The central portion is
necrotic, the peripheral portion made up largely of granulation tissue in which giant
cells are quite sparsely disseminated. Tubercle bacilli were not detected.

No. 331.—Holstein cow, 6 years old. Weight, 850 pounds. Calved January, 1892;
is giving milk. Pregnant since September 22, 1892.

March 21, 1893, midnight: First injection, 0.4 cc. tuberculin K. Before injection,
maximum temperature, 102° (6 p. m.); after injection, reached in seventeen hours,
106.2° (5p. m.). (For complete record see p. 66.)

_ April 12, 1893, midnight: Second injection, 0.25 cc. tuberculin S. Before injection,
Maximum temperature, 101.8° (8 a. m.); after injection, reached in eighteen hours,
105.8° (6 p.m.). (For complete record see p. 71.)

April 18, 1893: Killed for examination.

Autopsy.—The only tuberculous lesion in this case is represented by a caseous focus
about one-half inch in diameter, embedded in the caudal lobe of the left lung near
median border. This focus is adjacent to a small bronchus and is associated with a
tuberculous mass as large as a hemp seed. Scrapings from the inner wall of the
capsule inclosing the caseous mass negative as regards tubercle bacilli.

A guinea pig inoculated subcutaneously with some of the caseous mass died three
months later. The autopsy showed extensive tuberculous changes in the liver and
spleen and isolated caseous masses in the lungs.

No. 332.—Holstein cow, 7 years old. Calved spring of 1892 and 1s still giving milk.
Pregnant since August 27, 1892.

March 21, 1893, midnight: First injection, 0.4 cc. tuberculin K.

March 22,10 a. m.: Feces slightly softened. Before injection, maximum tempera-
ture, 102.4° (8p. m.); after injection, reached in twelve hours, 107.1°(12 a.m.). (For
complete record see p. 66.)

April 12, 1893, midnight: Second injection, 0.25 ce. tuberculin 8S. Before injection,
maximum temperature, 102.8° (4 p.m.); after injection, reached in eighteen hours,
106.2° (6 p.m.). (For complete record see p. 71.)

April 14, 1893: Killed for examination.

Autopsy.—The tuberculous lesions in this case were limited to one of the smaller
posterior mediastinal glands. A portion of this gland on section had a pale
grayish appearance, which on closer examination and especially after a short
sojourn in alcohol, appeared made up of very minute tubercles.

Sections of this region after hardening in alcohol were carefully examined. The
suspicious focus was shown to consist of an aggregation of tubercles, each provided
with one or more giant cells. In many of these from 1 to 3 tubercle bacilli
could be demonstrated by Gabbett’s stain.

There is evidence of former inflammation of the serous membranes of thorax in
slight but firm adhesion of various lobes of the lungs to each other, to the diaphragm
and the pericardium.

No. 333.— Jersey cow, 5yearsold. Weight, 600pounds. Calved, December 20, 1892,
and has not been served by bull since; is giving milk.

March 21, 1893, midnight: First injection, 0.3 ce. tuberculin K.

March 22,9 a. m.: Feces semifluid, much thinner than usual. Before injection,
maximum temperature, 102° (7 p.m.); after injection, reached in nine hours, 106.9°
(9a. m.). (For complete record see p. 66. )

April 12, 1893, midnight: Second injection, 0.25 cc. tuberculin 8. Before injec-
tion, maximum temperature, 102.4° (8 a. m.); after injection, reached in thirteen
hours, 105.6° (1 p.m.). (For complete record see p. 71.)

April 18, 1893: Killed for examination.

Autopsy.—In this animal the tuberculous infection is limited to the abdominal

cavity.
>

44

Mesenteric glands: Two are involved. One contains three foci, each about one-
eighth inch in diameter, two caseous and one calcareous. The other contains a
partly caseous, partly calcareous, focus three-eighthsinch in diameter, and one one-
eighth inch in diameter. Several glands contain worm tubercles.

Liver: Two portal glands are moderately enlarged. One contains three firm, dry,
casoous foci, the other contains two quite small yellowish foci.

In the large posterior lobe of the liver are two contiguous tuberculous foci
embedded in the liver tissue and reaching the convex surface. One of these is fully
3 inches long and 2 inches thick. The other is about 1 inch in diameter. They
are both made up of an abundance of dense connective tissue inclosing a large num-
ber of small, partly caseous foci, some of which are one-fourth inch in diameter.
The diaphragm is adherent to the liver over these foci.

In the region of the second stomach, between it and the diaphragm, there are
firm adhesions occasioned by traumatic inflammation and suppuration. When the
adhesions are severed, several masses of firm, almost cartilaginous tissue (indurated
glands) (?) are found in this adherent area surrounded by more or less gelatinous infil-
tration. The firm masses are softened centrally (abscesses).

No. 334.—Holstein cow, 3 years old. Weight, 1,000 pounds. Calved September,
1892; is giving milk. Pregnant since February 6, 1893.

March 21, 1893, midnight: First injection, 0.4 cc. tuberculin K. Before injection,
maximum temperature, 102.4° (3 p. m.); after injection, reached in fifteen hours,
102.99 (3 p.m.). (For complete record see p. 66.)

April 12, 1893, midnight: Second injection, 0.25 cc. tuberculin §. Before injec-
tion, maximum temperature, 101.8° (9 a.m.); after injection, reached in seventeen
hours, 102.59 (5 p.m.). (For complete record see p. 71.)

May 25, 1893, midnight: Third injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 102.2° (6 p. m.); after injection, reached in seventeen hours,
102.7° (5 p.m.). (For complete record see p. 74.)

July 6, 1893: Killed for examination.

Autopsy.—In the left bronchial gland a soft, caseous focus about one-half inch in
diameter situated in the center of the gland. In the mediastinal gland near it, rest-
ing loosely on the root of the left bronchus, a similar focus. (Unfortunately the tho-
racic glands, removed for further examination in the laboratory, were rejected
through some inadvertence. Theremaining glands were of normal size, and if tuber-
culous the foci must have been quite small. )

No. 335.—Jersey cow, 5 years old. Weight, 700 pounds. Calved January 28, 1893,
and has not been served by bull since; is giving milk.

March 21, 1893, midnight: First injection, 0.4 cc. tuberculin K.

March 22, 9:30 to 10:30 a. m.: Marked trembling. Before injection, maximum
temperature, 102.29 (8 p. m.); after injection, reached in seventeen hours, 107.8°
(5p.m.). (For complete record see p. 66.)

April 12, 1893, midnight: Second injection, 0.25 cc. tuberclin 8. Before injection,
maximum temperature, 102° (4 p. m.), after injection, reached in twelve hours, 105.2°
(12 a.m.) (For complete record see p. 71.)

April 25, 1893: Killed for examination.

Autopsy.—Left retropharyngeal gland is about 3} inches long and 1 to 1} inches
thick, more or less nodular or lobulated. It contains an aggregation of soft,
caseous foci from one-fourth to one-half inch in diameter. Foci in periphery of
gland smaller and firmer than those centrally situated.

Thorax: The large posterior mediastinal gland contains two small firm caseous
foci; the contiguous gland contains about ten foci one-eighth to three-sixteenths
inch in diameter.

Of the bronchial glands the small one near the root of right main bronchus con-
tains a firm caseous mass equal to one-half the bulk of the gland.

45

Abdomen: In one of the portal glands two firm, caseous masses about three-
eighths inch in diameter. The liver tissue contains a few subcapsular nodules of
parasitic origin.

No. 336.—Jersey cow, 8 years old. Weight, 800 pounds. Calved in spring of 1892,
and is still giving milk. Not pregnant, and has not been served by bull since July
25, 1892. ;

March 21, 1893, midnight: First injection, 0.4 cc. tuberculin K. Before injection,
maximum temperature, 102.69 (7 p. m.); after injection, reached in seventeen hours,
106° (5 p.m). (For complete record see p. 66.)

April 12, 1893, midnight: Second injection, 0.25 cc. tuberculin S. Before injection,
maximum temperature, 102.8° (5 p. m.); after injection, reached in seventeen hours,
104.99 (5 p.m.) (For complete record see p. 71.)

May 25, 1893, midnight: Third injection, 0.35 ce. tuberculin 8. Before injection,
maximum temperature, 102.9° (6 p. m.); after injection, reached in twenty hours,
103.89 (8p. m.) For complete record see p. 74.)

June 1, 1893: Killed for examination.

Autopsy.—Thorax: In the caudal lobe of right lung near the caudal extremity and
about 3 inches from lateral border are three tuberculous foci in the lung tissue.
One of these is situated on the periphery of a small bronchus and is about one-half
inch in diameter, one section yellowish, the center broken down into a soft pus-like
mass. The second focus is near the first, embedded in a lobule. Softening not yet
begun. The third focus is nearer the first and is like second, but somewhat smaller.
Near these on ventral surface of the lungs and directly under the same bronchus is
a subpleural tuberculous mass resembling the second and third described. Slight
yellowish mass in bronchus near these foci. The large posterior mediastinal gland
is about 4 inches long and 1 to 1d inches thick. On section fully one-half of the gland,
especially the cortex, is involved and appears as a grayish mass in which there is an
abundant network of yellowish lines and patches. Only one of the other medias-
tinal glands shows distinct tuberculous infection. In caudal portion is contained a
tuberculous mass about one-half by one-fourth inch in diameter, which is in the*same
condition as gland just described. The bronchial glands are free from injection and
quite markedly pigmented.

Abdomen: One of the mesenteric glands contains a tuberculous mass 1 by 4 by 1 by 2
inches in size. On section this mass is oval in outline, sharply defined, firm. It con-
sists of a close network of yellowish lines and patches, among which only a little
grayish tissue is still visible. The process here seems slightly more advanced
toward necrosis than in the thorax. Some worm nodules are also present in the
mesenteric glands.

No. 337.—Cow, 12 years old. Weight, 950 pounds. Calved in spring of 1892, still
. giving milk. Pregnant since September 15, 1892.

March 21, 1893, midnight: First injection, 0.4 ce. tuberculin K.

March 22, 10a. m.: Periods of slight trembling. Before injection, maximum tem-
perature, 102.6° (8p. m.); after injection, reached in fourteen hours, 105.5° (2 p. m.).
(For complete record see p. 67.)

April 12, 1893, midnight: Second injection, 0.25 ce. tuberculin S.

April 13, 10 to 10:30 a.m.: Occasional periods of slight trembling. Before injec-
tion, maximum temperature, 102° (8 p.m.); after injection, reached in nineteen hours,
105° (F p.m.). (For complete record see p. 71.)

April 14, 1893: Killed for examination.

Autopsy.—A soft caseous mass in one of the retropharyngeal glands one-half inch
in diameter:

Thorax: Jn the principal lobe of the right lung a large tuberculous focus resem-
bling closely that of No. 318 both as to the condition of the contents and the absence
of any surrounding infiltration. The small air tube leading to it is occluded with
yellowish cheesy material. ‘Tubercle bacilli not detected in it.

46

One of the posterior mediastinal glands contains 4 caseous foci from one-fourth
to one-half inch in diameter. The bronchial gland at root of left bronchus contains
four quite small yellowish foci.

Abdomen: Mesenteric glands involved. A considerable number contain foci vary-
ing from one-eighth to one-fourth inch in diameter. They are very firm to the touch
and project above the surface of the gland as round yellow bodies. The glands are
not enlarged. The tubercular foci are all firm, necrotic, some largely calcareous.
Besides the tuberculous changes, worm nodules are not uncommon.

No. 838.—Jersey cow, 3 years old. Weight, 500 pounds. Calved January 28, 1892.
Condition, very thin. Shows symptoms of advanced tuberculosis, and has been
isolated from herd for from fifteen to eighteen months.

March 27, 1893, midnight: Injected 0.3 cc. tuberculin Kk. Before injection, maxi-
mum temperature, 103.6° (2 p. m.); after injection, reached in seven hours, 103.8°
(7a.m.) (For complete record see p. 67.)

April 4, 1893: Killed for examination.

Autopsy.—Case of advanced tuberculosis. Retropharyngeal glands, tonsils,
larynx, trachea, bronchi, lungs, thoracic glands, and the pleura extensively diseased.
In the abdomen the various groups of lymphatics greatly enlarged and tuberculous.
The omentum and serosa of stomachs are beset with patches of confluent tubercles.

All Peyer’s patches of the small intestine are extensively infiltrated with tuber-
cles and the mucosa ulcerated. The spleen, liver, and kidneys (excepting the serous
coverings) are free from tuberculous changes recognizable with the unaided eye.
The udder and pubic glands are likewise free from infection.

No. 839.—Cow, fifteen-sixteenths Holstein, 7 years old. Weight, 1,000 pounds.
Calved summer of 1892, and is still giving milk. Pregnant since December 13, 1892.

March 27, 1893, midnight: First injection, 0.4 ce. tuberculin K. Before injection,
maximum temperature, 102° (5 p. m.); after injection, reached in eleven hours,
103.69 (11 a.m.). (For complete record see p. 67.)

May 1, 1893, midnight: Second injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature, 103° (5p. m.); after injection, reached in nineteen hours,
103.5° (7p. m.). (For complete record see p. 71.)

May 25, 1893, midnight: Third injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 103° (6 p. m.); after injection, 102.69 (5 p. m.). (For com-
plete record see p. 74.)

June 19, 1893: Killed for examination.

Autopsy.—Thorax: In the lungs there are not less than 8 isolated tuberculous foci.
Five of these are in the right caudal, 2 in the left caudal, and 1 in the right cephalic
lobe. In the right caudal lobe 3 foci are situated along the dorsomedian region (i.
e., in that portion of the lung tissue resting against the sides of the vertebra and the
dorsal end of the ribs). They are situated above (or dorsal of) the main bronchus,
excepting the most caudal of the 3 which surrounds the bronchus. These foci
are visible on the lung surface. They vary in size, the smallest being three-fourths
inch in diameter, the largest 2 or 24 inches in diameter. They consist in the main of
aggregations of cysts containing very soft, cheesy masses, inclosed in thin-walled
capsules. These cysts vary in diameter from one-eighth to three-fourths inch. The
focus nearest the root of the lobe is made up of several such cysts and a considerable
mass of lung tissue which appears to consist of a large number of small cheesy foci.
The peculiar yellowish mottled appearance of this tissue from the pleural surface
and a careful inspection of the cut surface suggests aspiration of cheesy matter
resulting in caseous broncho-pneumonia. The main bronchus, moreover, contains
some loose cheesy masses. This lobe contains, in addition to these 3 foci, 2 small
embedded ones situated near the lateral margin of the lobe, of which 1 is cheesy, the
other firm, grayish in color.

In the left caudal lobe there are 2 foci. One in the dorsomedian region under the
pleura, about three-fourths inch in diameter, consists of a soft central mass surrounded

AZ

by an aggregation of small cheesy masses. The other is about 1 inch in diameter
and is made up entirely of soft cheesy foci.

On the caudal margin of the second cephalic lobe there is a small triangular region
of very thin collapsed tissue in which are situated 3 small masses, consisting of
a dense, grayish tissue inclosing a yellow cheesy nucleus.

Thoracic lymph glands: Large posterior mediastinal gland contains near the caudal
end a dry, cheesy, partially gritty focus measuring one-half by one-fourth inch.
In the same region there are 2 cheesy foci about three-sixteenths inch in diam-
eter. Toward the middle there are 2 minute yellowish foci one-sixteenth inch in
diameter. In mediastinal gland, situated on the esophagus at the level of the bifur-
cation of the trachea, there is 1 small tubercle, with cheesy, yellowish center,
about one-sixteenth inch in diameter. In bronchial gland at root of left bronchus
there are 2 small foci, one-sixteenth and one-eight inch in diameter, of a grayish
color and yellowish center. In the gland at root of right supernumerary bronchus
there is a focus one-fourth inch in diameter, with yellowish, cheesy contents embedded
in a firm, grayish capsule, and a second smaller focus composed almost entirely of
firm, grayish tissue, with a minute yellowish center.

In 3 of the mesenteric glands there are several isolated tubercles, quite small,
having a yellowish color. One gland also contains an aggregation of such tuber-
eles.

No. 340.—Cow, fifteen-sixteenths Holstein, 9 years old. Weight, 1,100 pounds.
Calved summer of 1892; is still giving milk. Pregnant since January 13. 1893.

-March 27, 1893, midnight: First injection, 0.4 cc. tuberculin K. Before injection,
maximum temperature, 101.6° (4 p. m.); after injection, reached in ten hours, 104°
(10 p. m.). (For complete record see p. 67.)

May 1, 1893, midnight: Second injection, 0.25 cc, tuberculin 8. Before injection,
maximum temperature, 102.2° (4 p. m.); after injection, reached in fifteen hovrs,
102.6° (3p. m.). For complete record see p. 72.)

May 23, 1893: Killed for examination.

Autopsy.—In this case tuberculous lesions could not be found. In the uterusa
a fetus about 3 months old, dead and beginning to disintegrate. Free from odor.

No. 341.—Half Holstein cow, 9 years old. Weight, 900 pounds. Calved spring
of 1892; still giving milk. Not pregnant, and has not been served by bull since
June 24, 1892. ‘

March 27, 1893, midnight: First injection, 0.4 cc. tuberculin K. Before injection,
maximum temperature, 103° (9p. m.); after injection, reached in eleven hours, 105°
(jl a.m.). For complete record see p.. 67.)

May 1, 1893, midnight: Second injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature, 103.4° (6 p. m.); after injection, reached in twelve hours,
106° (12 a. m.). (For complete record see p. 72.)

May 19, 1893: Killed for examination.

Autopsy.—Lungs: In the right caudal lobe beneath the pleura of the dorsal sur-
face there is a tuberculous focus about 14 inches in diameter, not directly connected
with any traceable branch of the bronchus. This focus is made up of lobules in
different stages of caseation. In one lobe the cheese is very soft and easily removed.
In others it is slightly firmer, but likewise removable without difficulty. The lung
tissue surrounding this focus for a distance of one-half to 1 inch contains a consid-
erable number of minute grayish tubercles. In the trachea, near the bifurcation,
there are several small masses of cheesy matter lying loose on the mucous membrane.
There are also 2 tuberculous patches on the mucosa, 1 at the place of bifurca-
tion, the other about 1 inch from it, both made up of fresh tubercles mingled
with the tubercular ulcers, which have elevated margins undermined with cheesy
deposits. These ulcers are abont one-fourth inch in diameter.

Thoracic glands: In the gland at root of left bronchus there are 5 or 6 small
grayish tubercles, a few with minute yellowish centers. In the caudal mediastinal

48

gland, near its middle portion, there is one completely calcified focus about one-
fourth inch in diameter, and several small translucent tubercles about one-six-
teenth inch in diameter, all situated in the cortex. In middle of the same gland
there is a constricted, retracted portion containing a few tubercles. In an adjacent
portion also a few barely recognizable grayish tubercles. In another portion of
cortex a small patch of recent infiltration.

No. 342.—Cow, fifteen sixteenths Holstein, 9 years old. Weight, 900 pounds.
Calved December 14, 1892, and has not been served by bull since; is giving milk.

March 27, 1893, mee es First injection, 0.4 ce. tuberculin K,

March 28, 8:30 a, m.: Trembling quite marked and stands with back slighly
arched. Before injection, maximum temperature, 102.2° (5 p. m.); after injection,
reached in twelve hours, 106° (12 a. m.). (For complete record see p. 67.)

May 1, 1893, midnight: Second injection, 0.25 ec. tuberculin S. Before injee-
tion, maximum temperature, 103.4° (5 p. m.); after injection, reached in nineteen
hours, 104.2° (7 p.m.). (For complete record see p. 72.)

May 19, 1893: Killed for examination.

Autopsy.—Thorax: In gland at root of left bronchus half a dozen tuberculous foci
one-sixteenth to one-fourth inch in diameter, caseous and still firm. In the cephalic
end of the large mediastinal gland one small similar focus. Traumatic inflanima-
tion of walls of second stomach owing to presence of wire 4 inches long.

(Owing to some mistake the affected glands were not taken to the laboratory for
reéxamination. Hence the notes are somewhat incomplete. )

No. 343.—Cow, fifteen-sixteenths Holstein, 6 years old. Weight, 1,100 pounds.
Calved during summer of 1892; still giving milk. Served by bull January 11, 1893,
but is not pregnant.

March 27, 1893, midnight: First injection, 0.4 ce. tuberculin K,

March 28: 7:30 a.m., respiration accelerated; pulse, 8). Slight trembling with
twitching of muscles, especially in the gluteal region. The hack is slightly arched;
11a. m., feces considerably softened. Before injection, maximum temperature, 101.6°
(4p.m.); after injection, reached in ten hours, 107° (10a.m.). (For complete record
see p. 67.)

May 1, 1893, midnight: Second injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 102.6° (6 p.m.); after injection, reached in twelve hours,
106.2° (12a.m.). (For complete record see p. 72. )

May 12, 1893: Killed for examination.

Autape, —A soft cheesy focus one-half inch in aiaineter in the left retropharyn-
geal gland.

Lungs: In the caudal lobe of the right lung on the lateral margin a small trian-
gular area contains a few soft caseous foci and some more recent infiltration. In the
caudal fifth of the same lobe there is a very small solitary, cheesy focus, and two of
the same character in the same situation in the corresponding lobe of the left lung,

A much larger triangular focus of disease at the caudal border of the right ven-
trallobe consisting of an aggregation of cheesy masses up to one-fourth ineh in
diameter.

Thoracic glands: These are quite extensively diseased. That one of the series of
posterior mediastinal glands which is situated near the arch of the aorta is fully 8
inches long and 5 inches wide. Itis made up of a large number of communicating
cavities filled with cheesy, partly liquefied matter. Another gland of the same series
situated nearer the diaphragm is as large as a fist, and in the same condition as the
preceding gland. The large mediastinal gland is not so far advanced. It contains
a small number of cheesy tubercles and more or less recent infiltration. The 3
bronchial glands, one at the root of left bronchus, another at root of right bronchus,
and the third atroot of right supernumerary bronchus, are each as large as a fist,
with contents cheesy and partly liquefied. A number of small glands not usually

49
detected in the normal lung, including the anterior mediastinal, are enlarged and
contain one or more tuberculous foci.

Abdomen: Onthe tendinous portion of the diaphragm, mainly the right side, are.
a considerable number of flattish tubercular excrescences from one-eighth to three-
fourths inch in diameter, consisting of agglomerations of tubercles some of which
show slight central caseation. A thin membranous expansion extends from the
diaphragm to the cephalic lobe of the liver, forming a false ligament. Along its
free margin are a few tuberculous inasses from one-eighth to one-fourth inch in
diameter. One tubercle is firmly adherent to capsule of liver where the false liga-
ment is attached to it. This mass is about one-half inch in diameter and one-
fourth inch thick and made,up of a capsule of dense connective tissue inclosing a
firm yellowish caseous mass.

The parenchyma of the liver and the portal glands are normal.

The small extremity of spleen is adherent over an area about 6 inches square to
reticulum by means of dense inflammatory tissue, one-half to 1 inch thick, con-
taining abscesses and surrounded by gelatinous cedematous tissue. The spleen
itself not affected. Cause, probably some foreign body.

No. 344.—Cow, fifteen-sixteenths Holstein, 6 years old. Weight, 900 pounds.
Calved August, 1892; is giving milk. Pregnant since January 5, 1893.

March 27, 1893, midnight: First injection, 0.4 cc. tuberculin K. Before injec-
tion, maximum temperature, 101.8° (5 p.m.); ofter injection, reached in twelve
hours, 105.2° (12 a.m.). (For complete record see p. 67.)

May 1, 1893, midnight: Second injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 102.49 (6p. m.); after injection, 102° (5 p.m.). (For com-
plete record see p. 72.)

May 16, 1893: Killed for examination. :

Autopsy.—In the right retropharyngeal gland are 3 tuberculous foci, each about
one-half inch in diameter and consisting of grayish tissue penetrated by a network
of yellowish lines.

No other tuberculous lesions discoverable.

Adhesion of cephalic end of liver to neighboring organs by means of inflammatory
tissue containing a small abscess (traumatism). Sections of a portion of the retro-
pharyngeal gland hardened in alcohol show that the region of the gland invaded
is made up of a number of small foci, provided with giant cells.

No. 345.—Half Holstein cow, 9 years old. Weight, 1,000 pounds. Calved August,
1892; is giving milk. Pregnant since January 11, 1893.

March 27, 1893, midnight: First injection, 0.4 cc. tuberculin K. Before injection,
maximum temperature, 101.6° (4 p. m.); after injection, reached in twelve hours,
106.9° (12 a. m.). (For*complete record see p. 67.)

May 1, 1895, midnight: Second injection, 0.25 ce. tuberculin 8S. Before injection
maximum temperature, 102.4° (6 p. m.); after injection, reached in nineteen hours,
106.4° (7p. m.). (For complete record see p. 72.)

May 12, 1893: Killed for examination.

Autopsy.—The only tuberculous lesions in this case were found in the posterior
mediastinal and the bronchia) glands.

In the large posterior mediastinal gland there are about 6 foci one-eighth inch in
diameter projecting as roundish bodies of a grayish translucent appearance above
the cut surface. Each contains a yellowish necrotic center.

In the gland at root. of left bronchus there are about 10 precisely similar foci.
In the small gland at the root of the right bronchus, 1 similar focus.

Old fibrous adhesions between lungs and diaphragm, of slight extent.

No. 346.—Half Holstein cow, 9 years old. Weight, 1,000 pounds. Calved Septem-
ber, 1892; is giving milk. Pregnant since March 14, 1893.

March 27, 1893, midnight: First injection, 0.4 ce. tuberculin K. Before injection,
maximum temperature, 101.8° (5 p.m.); after injection, reached in nineteen hours,
106.49 (7 p.m.). (For complete record see p. 67.)

2891—No. 7 4

50

May 1, 1893, midnight: Second injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 102.6° (6 p.m.); after injection, reached in nineteen hours,
103.5° (7 p.m.). (For complete record see p. 72.)

May 16, 1893: Killed for examination.

Autopsy.—Thoracie glands: The gland at root of left bronchus made up of 3
separate glands. In one of these glands a tuberculous focus is one-fourth inch in
diameter, of a gelatinous appearance, spongy, with yellowish particles sprinkled
through it. In a second gland 3 similar foci, 2 one-fourth inch and 1 one-eighth
inch in diameter. The large posterior mediastinal gland, about 5 inches long,
one-half inch thick, and 2 inches wide at widest portion, contains tuberculous foci
from one-half to one-fourth inch apart, situated mainly in the cortex. Foci most
numerous at caudal end, where they are from one-eighth to one-fourth inch in diam-
eter, and have a gelatinous appearance, with yellowish lines sprinkled in. They
project above cut surface. These foci all appear to be of the same age, except two,
one of which is about one-half inch in diameter and slightly older; the other is
also one-half inch in diameter, and made up. entirely of coarse, gritty particles.
The gland at this point is retracted. In one of the more cephalic mediastinal glands
3 or 4 similar tuberculous foci.

Abdomen: In one mesenteric gland there is a tuberculous foci three-eighths inch
in diameter, consisting of very firm cheesy material, in which is embedded a central
calcareous particle. Traumatic inflammation around cephalic end of liver.

No. 347.—Holstein heifer, 2 years old. Weight, 600 pounds. Has never been
served by bull.

April 12, 1893, midnight: First injection, 0.2 ce. tuberculin 8.

April 13, 8:30 to 9 a.m.: Trembling very marked. Before injection, maximum
temperature, 102.8° (4 p.m.); after injection, reached in sixteen .hours, 106.8° (4
p-m.). (For complete record see p. 67.)

May 1, 1893, midnight: Second injection, 0.2 cc. tuberculin 8. Before injection,
imaximum temperature, 103.6° (5 p.m.); after injection, reached in nineteen hours,
104.29 (7 p.m.). (For complete record see p. 72.)

May 5, 1893: Killed for examination.

Autopsy.—The tuberculous changes in this case are likewise confined to the thoracic
lymph glands. :

In three of the posterior mediastinal glands there are regions made up entirely of
dense aggregations of grayish tubercles (recent infiltration). In one of these glands
there is a small calcareous focus in the midst of the recent infiltration.

In the gland at the root of the left bronchus and in the one in the angle of bifur-
cation there are similar foci in which yellowish centers are visible.

No. 348.—Jersey cow, 8 years old. Weight, 800 pounds. Gave birth to triplets
eighteen months ago and has not been in heat since; is not giving milk,

April 12, 1893, midnight: First injection, 0.25 cc. tuberculin 8S. Before injection,
maximum temperature, 102.79 (4 p.m.); after injection, reached in seventeen hours,
106.2° (5 p.m.). (For complete record see p. 67.)

May 1, 1893, midnight: Second injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature, 102.2° (8 p.m.); after injection, reached in seventeen hours,
103.2° (5 p.m.). (For complete record see p. 72.)

May 3, 1893: Killed for examination.

Autopsy.—Thorax: The large posterior mediastinal gland is 4 inches long and one-
half inch thick (only slightly larger than normal). In the cortex are not less than
10 to 15 tuberculous foci up to one-fourth inch in diameter. Some are calcareous,
others are in a state of partial necrosis. In another gland of the same group is a
small calcareous focus.

Abdomen: In one mesenteric gland several small tuberculous foci. Horns of
uterus more or less thickened (subinvolution). In the cavity some glairy fluid con-
taining yellowish lumps.

51

No. 349.—Jersey cow, 4 years old. Weight, 750 pounds. Pregnant the first time
since October 22, 1892.

April 12, 1893, midnight: First injection, 0.25 ce. tuberculin 8.

April 13, 7:40 to 8:40 p.m.: Frequent and marked periods of trembling. Before
injection, maximum temperature, 102.6° (4 p.m.); after injection, reached in ten
hours, 106.7° (10 a. m.). (For complete record see p. 68.)

May 1, 1893, midnight: Second injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 102° (4 p. m.); after injection, reached in nineteen hours,
103.8° (7 p. m.). (For complete record see p. 72.)

May 5, 1893: Killed for examination.

Autopsy.—The tuberculous changes are limited to the thoracic lymph glands.

The bronchial gland at root of left bronchus as large as a hen’s egg, more or less
furrowed and lobulated. Its center “is occupied by a completely calcified focus
three-eighths inch in diameter. Throughout the remainder of the gland are dissem-
inated yellowish foci one-eighth inch in diameter and one-eighth to one-fourth
inch apart, projecting above the cut surface. In the large posterior mediastinal
gland there are several foci of disease. One, near one extremity of the gland
which is more or less nodulated, cunsists of an aggregation of small tubercles con-
taining yellowish calcareous nuclei. In the center of the gland there is an aggre-
gation of partly caseous tubercles surrounded by a zone of more recent infiltration.

No. 350.—Jersey bull, 6 years old. Weight, 1,400 pounds.

April 12, 1893, midnight: First injection, 0.35 ce. tuberculin 8.

April 13,8:30 to 9:30 a.m.: Very uneasy in stall. Stands with body drawn up
and back very much arched. Very violent and continuous trembling. Before injec-
tion, maximum temperature, 101.6° (3 p. m.); after injection, reached in ten hours,
106° (10 a. m.). (For complete record see p. 68.) —

May 1, 1893, midnight: Second injection, 0.35 cc., tuberculin 8. Before injection,
maximum temperature, 102.2° (5 p. m.); after naection: reached in seventeen hours,
105° (5 p.m.). (For complete record see p. 72.)

May 10, 1893: Killed for examination.

Autopsy.—In gland at root of left bronchus there is a considerable crop of minute
grayish tubercles, about one-sixteenth inch in diameter, and situated mainly in the
cortex. A few are larger than the rest and contain each a minute yellowish nucleus.
The small gland at root of right main bronchus contains three tubercles undergoing
necrosis, each one-sixteenth to one-eighth inch in diameter.

In one of the mediastinal glands a few small tubercles like those in left bronchial
gland.

No. 351.—Holstein bull, 2 years old. Weight, 850 pounds.

April 12, 1893, midnight: First injection, 0.25 ce., tuberculin S.

April 13, 8 to 9a. m.: Periods of very violent trembling every few seconds, amount-
ing almost to a violent shaking of the whole body. Before injection, maximum
temperature, 102.6° (5 p. m.); after injection, reached in nineteen hours, 106.7°
(7p. m.). (For complete record see p. 68.)

May 1, 1893, midnight: Second injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature, 102.4° (6 p. m.); after injection, reached in nineteen hours,
105.69 (7 p.m.). (For complete record see p. 72.)

May 3, 1893: Killed for examination.

Autopsy.—Lungs: There are not less than 5 tuberculous foci in the lung tissue.

One large one, 2 to 3 inches in diameter near the lateral margin of the left caudal
lobe, projecting slightly above the dorsal surface of the lobe when in state of col-
lapse. It consists of soft cheesy masses easily removed from the enveloping tissue.
The surrounding lung tissue is infiltrated with young tubercles. A second focus,
1 inch in diameter, situated along median border of the same lobe deeply embedded
in the lung tissue. The condition of this focus the same as that of the first.

52

Two smaller soft cheesy foci situated near cephalic margin of the same lobe each
one-half to three-fourths inch in diameter.

Three quite small glands embedded in the lung tissue of this lobe between the
pulmonary artery and main bronchus contain firm, partly necrotic foci. Inthe main
bronchus near its root a few submucous tubercles. In the right cephalic lobe
there is 1 soft cheesy focus about one-half inch in diameter.

Bronchial glands: The one at root of left bronchus about the size of a small fist.
The one at root of right supernumerary bronchus contains 10 to 15 tuberculous
foci. The one situated in the bifurcation is as large as a hen’s egg and almost
entirely converted into a caseous mass in which are embedded gritty particles. The
posterior mediastinal glands are also involved and contain numerous foci from
one-eighth to one-half inch apart, the larger soft and cheesy.

In general, all thoracic glands affected and a few large glands noted where in nor-
mal lungs they are so minute as to be overlooked.

The bronchial glands are farther advanced in disease than the mediastinals.

One gland removed with spleen, and in all probability belonging to the portal
glands, contains two tuberculous foci, yellowish, cheesy, still firm, and partly eal-
careous.

No. 352.—Holstein cow, 3 years old. Weight, 700 pounds. Calved March 19, 1893,
and has not been served by bult since; is giving milk.

April 12, 1893, midnight: First injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 103° (6 p.m.); after injection, reached in ten hours, 106.2°
(10a.m.). (For complete record see p. 68.)

May 1, 1893, midnight: Second injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature, 104° (5 p. m.); after injection, reached in seven hours, 104.3°
(7a.m.). (For complete record see p. 73.)

May 10, 1893: Killed for examination.

Autopsy.— Left retropharyngeal gland about 2 inches in diameter, slightly irregu-
lar in shape. Onsection the parenchyma is found containing tuberculous foci made
up of putty-like masses, mixed with a few calcareous particles. They vary from one-
eighth to linchin diameter, and are surrounded with considerable connective tissue.

No. 353,—Jersey cow, 4 years old. Weight, 600 pounds. Calved March 26, 1893,
and has not been served by bull since; is giving milk.

April 12, 1893, midnight: First injection, 0.25 cc. tuberculin 8. Before injection
maximum temperature 102.6° (4 p.m.); after injection, reached in seventeen hours,
103.8° (5 p.m.). (For complete record see p. 68.)

May 1, 1893, midnight: Second injection, 0.25 ec. tuberculin $8. Before injection,
minimum temperature 102.6° (5 p. m.); after injection, reached in nineteen hours,
104.3° (7a. m.). (For complete record see p. 73.)

May 3, 1893: Killed for examination.

Autopsy.—No tuberculous lesions were found in this animal.

No. 554.—Cow, fifteen-sixteenths Holstein, 9 years old. Weight, 1,100 pounds.
Calved March 28, 1893, and has not been served by bull since; is giving milk.

May 1, 1893, midnight: First injection, 0.25 ec. tuberculin 8. Before injection,
maximum temperature 103.5° (6p. m.); after injection, reached in twelve hours,
106° (12 a.m.) (For complete record see p. 68.)

May 25, 1893, midnight: Second injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature 102.6° (6p. m.); after injection, reached in eighteen hours,
103° (6 p.m.). (For complete record see p. 73.)

June &, 1893: Killed for examination.

Autopsy.—Thorax: In the lungs there are 4 foci of tuberculous infection, all
situated in the caudal lobes. They are best described separately.

Focus No. 1 is situated on the median edge of right caudal lobe about 14 inches from
caudal tip. The focusitself is about 1} inches long and nearly three-fourths inch in

53

diameter; afew distended tortuous vessels pass over its surface. It feels as if made
up of four or five quite firm and distinct foci. A small air tube leads directly to the
focus, and along its course there are several small tuberculous foci in connection
with its walls. The large focus is composed of several small foci easily separated by
teasing. Each contains a pasty, pale-yellow mass, inclosed in a rather thin capsule.
The remaining foci are situated in the left caudal lobe.

Focus No. 2 oceupies a position symmetrical with No. 1. It does not show on the
surface as does No. 1, but is easily felt with the fingers; slight catarrh of the air
tube leading to this focus. It consists of about one-half dozen nodules up to one-
half inch in diameter, situated around a somewhat dilated bronchiole. In the course
of the main bronchus and about 3 inches from the tip of lobe and about 2 inches
from the focus just described there are several small cheesy foci in connection with
the walls of the bronchus.

Focus No. 3 consists of a mass of firm nodules, varying in size up to one-half inch
in diameter and distributed over a region about 24 inches square and one-half inch
thick. Small air tubes are traceable in this focus. The larger nodules are cheesy,
like those described. There is some slight recent infiltration in the periphery of the
focus. The interlobular tissue is more or less increased in quantity.

Focus No. 4 consists of a number of small cheesy nodules, up to one-eighth inch
in diameter, covering an area of about 1 cubic inch and embedded in alarge amount
of firm connective tissue. There is in one place some recent infiltration on the
periphery.

The gland at the root of left bronchus is more or less irregular and nodular in out-
line, and contains a considerable quantity of connective tissue, and in its centera
cheesy mass about one-quarter inch in diameter. Scattered over the periphery are
three or four quite small gelatinous looking tuberculous foci, containing yellowish
necrotic masses. In the gland at root of the right supernumerary bronchus, which
is but slightly enlarged, there are three tuberculous foci from one-eighth to one-half
inch in diameter, with cheesy contents. The gland situated on dorsal surface of
trachea near supernumerary bronchus contains one gelatinous focus, yellowish in
color, and about three-sixteenths inch in diameter. The most caudal of the posterior
mediastinal glands is very irregular in outline, much nodulated andretracted. The
gland is of the usual length, and at its thickest portion is 1 by 14 inches thick. In the
center of this enlarged portion thereis acheesy mass, surrounded by connective tissue
from one-half to three-fourths inch in diameter. The nodules showing from the
exterior are, in part, free from any tuberculous deposit, and are due to retraction of
the gland tissue, probably a result of some previous infection. In one of the smaller
mediastinal glands there are three quite small gelatinous-looking nodules. The
small gland within the left caudal lobe, between bronchus and artery near their
origin, contains two tuberculous foci.

No. 355.—Holstein cow, 5 years old. Weight, 900 pounds. Calved summer of 1892.
Pregnant since August 31, 1892.

May 1, 1893, midnight: First injection, 0.25 cc. tuberculin 8. Before injection,
maxinum temperature 102.8° (5 p.m.); after injection, reached in fourteen hours,
105.49 (2 p.m.). (For complete record see p. 68.)

May 25, 1893, midnight: Second injection, 0.25 ce., tuberculinS. Before injection,
maximum temperature, 108.2° (8p. m.); after injection, 102.8° (7 a.m.). (For com-
plete record see p. 73.)

June 8, 1893: Killed for examination.

Autopsy.—Thorax: On the surface of the large posterior mediastinal gland’ there
are two round, projecting yellow, nodules, one-eighth and one-sixteenth inch in diam
eter. They are calcareous and the surrounding tissue free from any infiltration.

In the bronchial gland, at root of left bronchus,3 foci of similar size and char-
acter.

54

Abdomen: In one of the mesenteric vlands there is a group of three firm yellowish
tubercles (the whole one-fourth inch in diameter) in the cortical portion. In a
neighboring gland there is a similar group of somewhat larger tuberculous nodules,
The glands are not enlarged and there is no infiltration around the foci.

No. 356.—Cow, fifteen-sixteenths Holstein, 9 years old. Weight, 1,000 pounds.
Calved November, 1892; is giving milk. Served by bull March 6, 1893, but is not
pregnant.

May 1, 1893. midnight: First injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature 102° (4 p.m.); after injection, reached in seventeen hours,
104° (5p.m.). (For complete record see p. 68.)

May 25, 1893, midnight: Second injection, 0.25 cc. tuberculin S. Before injection,
maximum temperature 102° (6 p.m.); after injection, reached in eighteen hours,
102.89 (6 p.m). (For complete record see p. 73.)

June 12, 1893: Killed for examination.

Autopsy.—Thorax: In the caudal lobe of the left lung there is a tuberculous focus,
situated directly under the pleura of the dorsal surface close to the median edge
and4 or5 inches from the caudal tip. The pleura over this focus is slightly opaque,
and beneath it are three small tuberculous nodules, two of which contain a caseous
center. Thesfocus itself consists of a central soft caseous mass, inclosed in a rather
thick-walled capsule and surrounded by a zone of infiltrated tissue one-fourth to
one-half inch thick. The infiltration consists of tubercles up to one-eighth inch in
diameter, many of them caseous. An air tube is not traceable to it.

In the bronchus of this same lobe near its origin and in the trachea are 2 gray-
ish tubereular excrescences. The one in the trachea is about one-half inch in diam-
eter and projects one-half inch above surface. The center is depressed. The
whole appears as if the mucosa were lifted up by tubercular infiltration of the sub-
mucosa, Section of the tumor shows a caseous mass beneath. The excrescence
in the bronchus is more convex and projecting, otherwise there are no marked
differences.

In the large posterior mediastinal gland near one end are 4 completely calcified
foci about one-eighth to one-fourth inch in diameter. The gland itself is not
enlarged, and these foci feel as firm as bullets in the interior of the gland tissue.

No. 357, —Cow, fifteen-sixteenths Holstein, 8 years old. Weight, 1,000 pounds.
Calved July 1, 1893; is giving milk.

May 1, 1893, midnight: First injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature 102.8° (6 p.m. ); after injection, reached in fourteen hours,
108° (2p.m.). (or complete record see p. 68.)

May 25, 1893, midnight: Second injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature 105° (10 p.m.); after injection, 102.5° (7 a. m.). (For com-
plete record see p. 73.)

The elevation in temperature previous to inoculation was due to an unknown
cause; excepting it the cow was apparently in good health. She belonged to the
last of the series of tests in this herd, else a third injection of tubereulin would have
been made. (See Case No. 318.)

July 13, 1893: Killed for examination. *

Autopsy.—Tuberculous lesions not discoverable. In the udder a number of com-
pletely yellow regions indicating fatty degeneration of gland substance.

Marked interlobular and subpleural emphysema of the cephalic and ventral lobes
ofthe right lung and of the ventral lobe of the left lung. Uterus contains a milky,
very foul-smelling fluid. Calf born thirteen days ago.

No. 558.—Cow, fifteen-sixteenths Holstein, 6 years old. Weight, 1, 000 pounds.
Calved summer of 1892; is still giving milk. Pregnant since January 20, 1893.

May 1, 1893, midnight: First injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature, 102° (5 p. m.); after injection, reached in nineteen hours,

105.6° (7p. m.). (For complete record see p. 68.)
e¢

55

May 25, 1893, midnight: Second injection, 0.25cc. tuberculinS. Before injection,
maximum temperature, 101. 8° (6 p. m.); after injection, reached in seventeen hours,
102.99 (5 p.m.). (For complete record see p. 73.)

May 27, 1893: Killed for examination.

Autopsy.—Thorax: The most caudal of the posterior mediastinal glands has its
cephalic end considerably enlarged, three-fourths inch thick, and 14 inches wide. On
section the greater part is found to be in a condition of tuberculous infiltration, of
a grayish appearance, in which are embedded a considerable number of soft cheesy
foci containing a few gritty particles. One of these cheesy foci is fully one-half
inch in diameter. Along the middle portion of the same gland is another tubercu-
lous mass about 1 by 4 inch in size, containing 4 foci, some of which are firm and
yellow, others are still grayish with yellowish lines within them.

The second gland of this group has about one-fourth of its mass in the same condi-
tion as that just described. This gland is about 1 by 4 by 4 inch in size. The third
eland of the group, slightly larger than the second, is normal. The fourth gland,
which is 14 by 1 by 4 inch has two-thirds of its substance in the same tuberculous
condition. The fifth, sixth, and seventh glands of this group are normal.

The bronchial gland at root of right bronchus is slightly larger than normal and
contains a region of grayish infiltration about 1 inch in diameter, containing 6 or
more small yellowish foci, quite firm and gritty in the center. One mesenteric
gland contains in its co:tex a dozen or more small tubercles, some yellowish and
nearly one-eighth inch in diameter, projecting markedly above the cut surface.

Traumatic inflammatory adhesion between second stomach and neighboring
organs.

No. 359.—Holstein cow, 7 years old. Weight, 1,000 pounds. Calved, July, 1892;
is still giving milk. Pregnant since August 25, 1892.

May 1, 1893, midnight: First injection, 0.25 cc. tuberculin S. Before injection,
maximum temperature, 103.2° (6 p.m.); after injection, reached in fourteen hours,
107.3° (2p.m.). (For complete record see p. 62.)

May 25, 1893, midnight: Second injection, 0.25 ec. tuberculin 8. Before injection,
maximum temperature, 103.4° (6 p.m.); after injection, 103° (6 p.m.). (For complete
record see p. 73.)

May 26, 8p.m.: The cow gave birth to a healthy calf, after which the temperatures
were no longer taken.

June 15, 1893: Killed for examination.

Autopsy.—Thorax: In the right caudal lobe near the median border on the dorsal
aspect, and about midway between caudal and cephalic border there is a small focus
about 1 to 14 inches in diameter directly under the pleura, made up of a collection of ©
foci in various stages of degeneration. The innermost are soft, caseous, and sur-
rounded by a thick wall. Several of these communicate directly by means of small
openings with a small, dilated bronchus filled with yellowish, cheesy matter.
Some of the exterior foci are composed of a very thick grayish wall and asmall, very
soft, yellowish center. These are about one-fourth inch in diameter.

Large posterior mediastinal gland, the most candal of the series, is of the usual
size, but is found to contain firm nodules inits substance. On the flat surface oppo:
site the hilus there is a collection of nodules projecting above the surface, which on
section are made up of a central, yellowish core, surrounded by a grayish capsule.
On cutting into the gland there are found four or five separate regions of disease,
consisting each of one or more foci one-eighth to one-fourth inch in diameter, which
are firm, grayish on section, and have a yellowish, necrotic center. There is only
one gritty focus about one-eighth inch in diameter.

The next gland of the series is about 1 inch in diameter and contains about 4 one-
fourth-inch foci, all in the same condition as thosedescribed, Thethird gland, about
1 inch in diameter, contains1 such focus. The fourth gland, } by } inch insize, con-
tains 5 or 6 similar foci and 1 smaller gritty focus. The fifth gland, about one-half

56

inch in diameter, is very nodular and contains 1 central, completely calcified focus
and several peripheral foci with necrotic centers, like preceding. The sixth gland
is about 2 inches long, one-half inch thick, and feels very nodular to the touch. It
contains about one dozen foci from one-eighth to one-fourth inch in diameter, made
up of a grayish peripheral zone and a firm necrotic center. The seventh gland is
about I¢inches long, one-fourth inch thick, and contains 3 foci like those described.
The small gland between the two bronchi at the bifurcation, which is about one-
half inch in diameter, is almost entirely occupied by 2 foci, one-eighth and three-
eighths meh in diameter, of the same character as the preceding.

No. 360.—Cow, fiftcen sixteenths Holstein, 9 years old. Weight, 1,000 pounds.
Calved April 12, 1893, and has not since been served by bull; is giving milk.

May 1, 1893, midnight: First injection, 0.25 ce. tuberculin 8S. Before injection,
maximum temperature, 102.4° (4 p. m.); after injection, 102.8° (7 p.m.). (For com-
plete record see p. 68.)

May 25, 1893, midnight: Second injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature, 102.2° (6 p.m.); after injection, 102.5° (6 p.m.). (For com-
plete record see p. 73.)

July 6, 1893: Killed for examination.

Autopsy.—In the large posterior mediastinal gland there are 3 tuberculous foci
situated near the middle of the gland. They are respectively one-half, one-half,
and one-fourth inch in diameter. They are completely caseous, without any sur-
rounding infiltration, and embedded in considerable connective tissue, part of
which seems to belong to the scar of a healed infection. Slight adhesion of cephalic
end of liver. A guinea pig inoculated subcutaneously with some of the caseous
material July 7 died just two months after inoculation. The usual lesions of tuber-
culosis (advanced tuberculosis of liver, tubercles in lungs, and in Peyer’s patches of
the intestines) were present.

No. 361.—Holstein cow, 8 yearsold. -Weight, 950 pounds. Calved December, i892,
and is giving milk. Pregnant since March 9, 1893.

May 1, 1893, midnight: First injection, 0.25 ec. tuberculin 8. Before injection,
maximum temperature, 102.6° (5 p.m.); after injection, reached in nineteen hours,
105.8° (5 p.m.). (For complete record see p. 69.)

May 25, 1893, midnight: Second injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 102.4° (8 p. m.); after injection, 102.59 (7a.m.). (For com-
plete record see p. 73.)

May 27, 1893: Killed for examination.

dutopsy.—In the large posterior mediastinal gland there is 1 small, completely
calcified focus about one-eighth inch in diameter. It shows on the exterior asa
slight cicatricial constriction. There is 1 other calcified focus not more than one-
sixteenth inch in diameter. The gland itself is slightly larger than normal and
shows evidences of former inflammation. The left abdominal aspect of the dia-
phragm is very much thickened by inflammatory tissue of almost cartilaginous
firmness. The lesion is limited mainly to the muscular portion of the diaphragm,
and covers an area 4 to 6 inches in diameter. There is also considerable inflammatory
depositiin the form of a gelatinous exudate between the second stomach and the
liver. In this deposit are embedded a few suppurative foci.

No. 562.—Holstein cow, 11 years old. Weight, 1,100 pounds. Calved early in
summer of 1892, and is still giving milk. Pregnant since February 9, 1893.

May 1, 1893, midnight: First injection, 0.25 ec. tuberculin S. Before injection,
maximum temperature, 102.8° (5 p.m.) ; after injection, reached in eleven hours, 104.8°
(1la.m.). (For complete record see p. 69.)

May 25, 1893, midnight: Second injection, 0.25 cc. tuberculin 8. Before injection,
maximum temperature, 102.4° (8 p.m.); after injection, reached in eighteen hours,
103° (6 p.m.). (For complete record see p. 73.)

June 12, 1893: Killed for examination.

57

Autopsy.—Thorax: In the caudal lobes of both lungs there are three tuberculous
foci:

(1) In the left caudal lobe, about 1 inch from caudal extremity, is a collection of
two or three caseous, quite soft foci, the whole about one-half inch in diameter,
inclosed in more or Jess connective tissue, and with periphery free from recent infil-
tration. a

(2) Exactly corresponding in position to the preceding focus is one in the right
caudal lobe, consisting of a soft, cheesy mass inclosed in a capsule.

(3) In the left caudal lobe there is a second focus situated near median border of
lobe on its dorsal aspect and about 3 or 4 inches from the caudal tip of lobe. This
focus, 14 or 2inches in diameter, on first cutting into it, appeared as a very recent
infiltration. The almost normal jung tissue is studded with an immense number of
miliary tubercles. On closer examination a contiguous focus of small caseous masses
is found, and a small dilated air tube choked with caseous material in communica-
tion with this region.

The large posterior mediastinal gland contains three foci about one-fourth inch
in diameter. These appear as grayish, gelatinous-looking masses projecting above
the cut surface and containing some yellowish gritty particles. One of the other
glands of this series contains two sinall foci of the same character.

Bronchial gland at the root of left bronchus contains about six similar foci. The
glands at root of right bronchus, the one at the bifurcation, and the one at the root
of the right supernumerary bronchus contain each a single similar focus.

Yhree mesenteric glands contain each several smail, firm, yellow tubercles. A
fourth gland is as large as a hen’s egg, and on section the medullary portion is found
converted into a yellowish, still firm, necrotic mass.

No. 363.—Cow, seven-eighths Holstein. 9 years old. Weight, 950 pounds. Calved
January 31, 1893, and has not since been served by bull; is giving milk.

May 1, 1893, midnight: First injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature, 103.2° (6 p.m.); after injection, reached in fourteen hours,
106° (2p.m.). (For complete record see p. 69.)

May 25, 1895, midnight: Second injection, 0.25 ce. tuberculin 8. Before injection,
maximum temperature, 102.8° (8 p.m.); after injection, 102.7° (5 p.m.). (For com-
plete record see p. 73.)

June 19, 1893: Killed for examination.

Autopsy.—One of the retropharyngeal glands is somewhat enlarged and contains
a cheesy focus from one-half to three-fourths inch in diameter. The very soft con-
tents are surrounded by distinct, connective-tissue capsule.

Thorax: In the large posterior mediastinal gland, which is not visibly enlarged,
there is in the middle of its length along one border a region about 2 inches long
which appears very nodular from the exterior and feels firm and nodular to the
touch. In this mass only one distinctly tuberculous focus is found. This is about
three-sixteenths inch in diameter, firm, yellowish, and projecting markedly above the
eut surface. One other minute yellowish focus discovered in this gland. In
onewther mediastinal gland there is some firm, cicatricial tissue in the cortex indica-
tive of healed tuberculosis. In the gland situated on the dorsal aspect of the
trachea, near the right supernumerary bronchus, there is a similar circumscribed
mass of very fine nodular tissue and a minute yellowish tubercle. The right
ventral and principal lobes are firmly adherent to the diaphragm by means of deli-
cate connective-tissue expansions. Similar slight attachments are found between
pericardium and diaphragm and pericardium and the smaller lobes.

Abdomen: Over the cephalic half of the convex surface of the liver there are a
number of old, fibrous adhesions attaching the anterior to cephalic lobe and the
diaphragm. In the same lobe are several regions of yellowish infiltration, probably
of embolic origin and due to parasites.

Some of the coils of the small intestines are attached to the abdominal wall by
expansions of thin, membranous connective tissne. In many of the mesenteric
glands there are one or more worm tubercles,

The following case, one of the three bulls, was sent to the experiment station of
the bureau November 14, 1892, some months before the general test of the herd was
begun. On November 17 one of the cervical glands* was removed by Dr. Kilborne.
It was 3 to 4 inches in diameter, composed of a thick-walled sac and semifluid con-
tents. Two guinea pigs inoculated subcutaneously with some of the contents died
of tuberculosis

Three tuberclin injections were made in all, the results of which are given below:

First test.—Received an injection November 16, 6:30 a.m., of 0.5 ce. tubereulinum
Kochii.

Temperature before injection. Temperature after injection.
Nov. 14-430 pombe sere ees eee 104.'3" | Nov. 16—6:30/a. mi. > 227 =s eee 101. 4
6: 302p. Wi ope tate a 102. 2 9a... 22a eee 102.7
Nov ..15-—8 a. nls oe a tee eee ee 100. 0 aim. 2222.5 103. 6
12 m 100. 2 Lip... 2S eee 104, 2
A CE eee eee AR ae 100. 9 3 Pid). 2 104.2
8 p.m 101.6 | dpi... ee eee 104.6
T D.M. 2-2. = 103. 6
Orcp. hs: t Se ee 103. 0
Li psm:=. == ee 102.4
Nov..17—8 a. M222 52-22-22 eee 101.0
Lp. .5-¢2 2 eee 102.4
D P.M... 2S eee eee

November 17, 1892: Excision of the tubercular gland.
Second test.—Received an injection December 10, 1892, 6:30 a. m., of 0.15 ce.
tuberculin prepared in the chemical laboratory of the Bureau of Animal Industry.

Temperature before injection. Temperature after injection.

Dec. 98 aom) ota oe cae eee 101.0 | Dee. 10— 6:30 a. m...-.-, 222. ee Oe
ti oi ae er ce eh 100.8 | 9 dh. Ws. . 2's cie Seen
Ep eM es eee estes mace as nr 101.8 11:30 2.122 eee 102. 2

2): M:.. 22. 2.o eee 102.0
4)... .-.2 5.ccoe eee

6p. 222) eee 103. 2

3)... 22-5 ee 103. 0

11 p; m=). 22 eee 102. 8

| Dec. 11— 8 a.m. ....2.. 22 see eee
4 Doi... ..2-- 102.8

Dec. 12— 8 a2... =. eee 101.0

*Probably the one denominated post maxillary in this bulletin.—T. 8.
t Temperature taken immediately upon the arrival of the bull at the veterinary
station after he had been walking 3 to 4 miles from the Soldiers’ Home.

y=. Sn

59

Third test.—Received an injection January 20, 1893, 7 a.m., of 0.35 cc. tuberculin
prepared in the chemical laboratory of the Bureau of Animal Industry.

Temperature before injection. Temperature after injection.
a OK SMS see oe So KOS LOM OF anys 20 ease ee ae 100.8
12s Vitis hs Sa ee Bee ees 101. 4 | Grain ese aeiees Ue IO aes cms 102.2
5) J Dull Seren eee rae eee 101.0 | Ey STV ee eee era eine ne 103. 0
Le DEVO Sarasota he rah 102.6
| ST Oat eee s EPe Cemetetal 102.6
Gans <a ene 101.5
| Soh] Os 0d lr ee Ma ees ee 101. 2
| LORD Mase ee ee 101.0
[pean lO ay INS Sartre Sos See 100.5
De oe GL pe ks 100.8
Fi] Dolls NeRSeea a A Ake eres os 102.6

January 26, 1893: Bull killed and examined post-mortem.

Extensive tuberculosis of glands of head. Tuberculosis of bones of sternum
Axillary glands of both sides as large as hens’ eggs and cheesy.

Advanced tuberculosis of all lobes of the lungs, associated with cavities and more
or less fibroid induration. No pleural tuberculosis. All thoracic glands tubercu-
lous and some as large as the closed hand.

In abdomen, mesenteric glands as well as the peritoneum free from disease. The
portal glands free, but four cheesy foci in the liver tissue, one-half to 1 inch in
diameter. Spleen free. Some small tubercles in medullary portion of parenchyma
of kidneys near papille. :

In this animal the advanced stage of the gland disease, the cavities in the lungs,
the surrounding fibroid thickening, and the chronic generalized infection indicate
that this was a long-standing case.

TABLES GIVING THE TEMPERATURE AS TAKEN BEFORE AND AFTER
THE INJECTION OF TUBERCULIN.

By F. L. KinBporneE and E. C. SCHROEDER.

303 304 306 ell 314

| i
ae | Dec.6. Dec.7. | Dec.6. Dec.7. Dec. 6. | Dee.7. Dec. 6. | Dec.7. | Dec. 6. | Dec. 7.
|Betore.| Atter. ‘Before. After. | Before.| After. | Before.| After. | Before.| After.
|
DERN oseos=esen 102.0} 102.2; 100.8! 101-5; 101.4; 101.8; 101.5} 101.6] 101.2} 101.8
2) Rb liNs oo fegesoees 102.5 | 102.5 101.8} 102.2) 102.6 | 103.0! 102.5 | 102.6] 102.0} 101.8
iki) Gitte compe neaeee 102.2 | 102.0; 101.8! 101.8} 102.0] 102.5, 101.8] 102.0] 102.4 102. 2
AERO ONE x2. 2-1-1: | 100. 2 | 100.4 101.5 | 99.4 100.0) 100.2 99.5 99.5 | 99.8 99. 8
2 SNe ae See eee | 100.8 | 104.4 101.0! 101.2; 100.6 102.4) 100.2} 101.8) 101.2 102.5
4) Do Sas deaseeses | 102.2; 107.0, 101.8 | 102.4; 101.8; 105.2; 101.4; 104.8 feclO2) 5s) 10520
(Dense Speessess | 102.5) 106.6 102.2); 102.6} 102.3) 105.8) 101.5] 106.0} 102.2! 105.6
ie} [Po UN See okeeesecs | 101.5 | 105.4 | 101.2 | 102.5 | 101.4 | 106.0 101.2} 104.4 | 101.6; 106.0
Ch pein (Seas eae foeeseveverses PROD SO eesti } 102.2 | 105. 2 WIR Yscsete ee | 105.3
11 a.m., Dec.8---.|.----.-- | MOOG occas sec | 101.0 | 101.0 TOW |essce see | 100.8
| | | I

Injected tuberculin K 6 a.m. December 7, 1892.

60

Temperature as taken before and after the injection of tuberculin—Continued.

301 302
Feb. 1-2. Feb. 2-3. Feb. 1-2. Feb. 2-3.
Before injection. After injection. Before injection. | After injection.
Hour. Pel andr RA ein | en eek ea TOS G ae era Q ; oe
ee | § |\e8| ee | ¢ |28) 26 | $ | e8) Se eee
= | 2 i ge! 82 | a | es| BS | Se | Be | Se |S lee
a | aS A [rere | ite a oo |e | a | & &
Siacm ees eee 10022) Je etl ss 101.4] 54 POT SATS eeosce lanes | 101.2 | 54) 24
Oe 4: Serene ii Eee, ee 101.4] 54) 24|° 100.0 |.....- Longe 101.6) 54) 18
ae hy 1 ee eee ee 100.6 54; 16! 101.8) 54] 21, 100.6; 54/ 16] 101.3 54; 18
WOWMmotM Ae ees ae ly T0154: 50} 18] 101.3) 54 24| 100.6) 48 | 16) 1010 | eer
lepamena. ae ae 101.4] 54) 18} 1012) ~ 54 21} 100.6) 54°] . 20.) ~ 10120") Sadat
Sein were noes 101.6; 54/° 30/ 101.4) 54 18} 101.0 | 48 |. 18.) ° 101.3))9 S54seeeae
as ieee ee 102.0 vi 36} 101.7%} 51 18 | 101.4). 72)|) “325 90279 60; |.) 2d
Up amsce ates ee 101.8, 72; 36) 102.8y/ 90 24, 0ee 2a vie 32°| >) 10450016 72a aeemetD
BDA sche tee 101.8 60 30 103.3 90} 30} 101.5 66 | 30)! 105.4 96 30
Sn ddnk tae ee 101.6 60 | 32} 105.0 75 | 30'|- 101.4 60 30 106.6 84} 36
wine Be 101.2 |- 60°! 30) 106,4) ~ 84)" 24 | 101.0.) ~ 60)” 30) S1077aingn 33
Spent eee ee 101.5 54 30. 106.6 84 30.| 101.0} 54). 28 ea o7aD 90 +36
Dat espe ee tee 101.4 54 28 106.8 78 |° 30 | 101.0)" :54 | 28") 0Gi ial 30
HO ms sase oe 101.4 54 30 | 106.4 78 36} 101.3 54 | 30] 106.0) 84 30
Mnpsanies s2ce eee 101.4 | 56 30'| 105.8 | 72) 271 101-4 54; 30) 106.0] 84 30°
12 midnight...... 101.6 60 30! 106.2 75 30 | 100.8 70 |. 30.) 105,61) Si5euuemen
lier ieReeee eee 2 101.4 | 54 26 105.8 84. 30} 101.4! 66} 30} 105.0 72 30
Dee as eseeteee 101.5] 56] 30! 105.8 66 27| 101.0} 60} 30! 105.3) 69 36
Biactis son ewes 101.4 | 54 32 105.0 78 39 100.8! 54 27. | 10458 1° Paes
Tig fae eae Ok 100.9 54 32 | 105.2 | 66 30'| 101.2 |. 54] 24 | GOs (ea 36
Siasme.:s-6) oe 101.6 54 30 104.4 78 36| 101.7 | 54 21 | 103.9 |- 72 36
tae ee eae 101.9 72 30) 104.0] 72 36 |. 101.6} 66| 30}| 103.4) 9% 30
Tio Wi Gee oe ee 101.6 48 18 |. 103.2 | 9:72 42 | 101.7| 60 | 21) f03im 66 32
Syarine tales 101. 3 54] 18, ) 102:8 60| 36, 101.8)- 54| 24) 1025) 69 36
Or ee Inj. tubereulin S$ 102.4 60 40 Inj. tuberculin S. 102.4 66 30
Wijasnpsee. 228s esense- te fee 101.6 60 4 || ee ree {2 bee Es {i Sees. 101.8 60 24
LUGE V9) tp oe a Be, (Ma oy gh Soe 1015.9+\\ S54 eves al ae lis ae Sele eee 101.8) 57 27
U2 NOON. 2-7-2 -- be tae eels ces eet 101. 2 GG" 2230.9 Sa sea ae Perea 101.8}; (0 24
Digs De aes ee) ae ee oe eee 101.2 Bast ei. 3Bs aaa peee lay seg Bees 101.8 60 24
Ig Ry Ae ee Pepa | VP Rities I CG 101.2 | BF; acaba Bee tee teas |e 101.6 60 30
Spins. 2024, SEL Ne ee - | See 1O2S One 72 SONS Se bets Aer [Cine Sine eee 32 102.5 | 68 32
ADIN oE fieais kal ote rt eae eee el eames 102.2 78h pO dence. cath Eee eee 103.2 | 72| 36
30 304 *
Feb. 1-2. Feb. 2-3. Feb. 1-2. Feb. 2-3.
Before injection. After injection. Before injection. After injection.
Hour. aes aati te D ; mat - ee 7 : a | bee a %
Pa ESPEN ote os 2 2 thee 1S ee Bal 2
2 |@8| 53 | & | BS | 88 | 2 4 he) Se eee
3 | ZF) 55 ao | 2S ees =m | 2S] BE a | a5
=I 2 a) = o ® = ov CO) = <=
oF in = = a oH fy & a o i=
Le a 6 Te SR i he [CL Tiel Pad ge a SB ea 101.5 54 27 98 Gilienntonleoe eee 102.2 | 54 24
ADige im Sees sel OOO yee e eee 101.0 48 12-|'-1995'0, 1) ae 102.1) 48 21
Tas! ah ees 48 20} 100.6} 48 18) 98.8] 48 12°} 102. 2) 58 21
12moon. 5) seks 50 18 | 100.3} 48 18 | 100.0] 50, 12) 1014) “52 18
iba) ae eee 50 20 100.6) 57 24.| 100.9) 48} 161 D01jD | 954 18
Dy ip eee eae 4g | 20) 100.4) 48:1) “211 101.2) 54 1>. 18))-S10ie eee 18
Sipe ote |: 470 40| 101.8 51 24! 101.8 72 32| 101.9] 48; 21
Assam. foe es peasy 35 {7108.01 66 30 | 102.3 70.| -36 |) d02%2 78 36
Oeperthe ae aes eas | 66 24! 103.7 72 33'| 101.7. | 66 |. -30); “102i Se| eee 24
Byam 5. eee 66| 30| 104.1} 66) 30] 101.7|) 56|-22| 1026) “69 24
The ei ee eae ae ' 60! 30] 105.2] 60) 36] 101.4] -62 | “26% 102,00 sag 21
Bpim se eee 54| 26] 105.6] 63 33 | 101.2] 54] 20] 101.4] 60] — 21
io iteenan son ehe | 60) 36) 104.8) 63 30 | 101.4] 60| 30] 101.6} 60 24
10pm posse GO! 36) 105.4] 63| 24] 101.2) 56] 30) 1014)” 60 24
Bly opps eee eee 66 30} 104.2| 72] 36} 101.6 54} 24] 101.6 60 24
12 midnight....-- 54 30] 104.0} 72]. 36, 101.0) 54) 241 OG) 60 21
Dayar eee se | 54) 36} 103.8; 57) 27] 100.8) 60; 24| 101.8| 60 18
Dia, eH sees ace ee 50 | 32 104.0 66! 42] 101.2 60 | 24] 101.4] 60 15
Basins veeseee 48.) 21 | 10407). 63.| 88-1 S0165| 2 oa 225) Sota aie nes 18
Aa Tee eee | 54 30.|° 10858.) 72-0 89"\" Tota 54| 24| 101.6] 60 24
Hiaasen | 48°|.° 24°|- 103..0') 60} 38) 1029 |" 54] ~ 24 Soap mae 24
Gam aod 54| 24.1 108.2) - 66) 36:| 10158") 160.) 24) | etOo sn eman 22
TAU 3 oes ye ee 48 | 241 108.4 | 63} 45) 1019 |- 54.) 21) SOT 5e ean 15
Sanimess< Soe 60 | 24) 102.0} 66] 48] 101.8 60| 24] 101.4] 60 24
Sagmiveccos, he] Inj. tubereulin S. 102.5 66 42 Inj.tubereulin S. | 101.7 66 24
Opa ince ae eee oeeetse lessees oe TODHO7 | dal MOS eet Bis oe Hei. ee jee 101.0} 57 21
TA) eee soe ees Nal ea ee ee 102.0] 54 5 (OP eae Pee | eS 101.0] 60 18
IO GGNET oe ee Nel eee aces [oe TOL6 |) 58") “aR ee. Fd ee es 100.8] 54] 24
Upsnes fect cere alae fee eee ee | oe LOUA $0" /60|s aoa: aos oto eee teens 101.0| 54 18
Shans eee et eek sel ee ae gt 3 Mash Peas | See ee ec oe 101.4] 54 24
3/pemM ee saa. ote (Sel ee ere Veta tase (ears 102.4 78 DAD |e eng eee ne (ee so 102.0 72 36
Asp ianee-ek eee | Meee | See a 103. 2 68; 48 crete Jrsieeze ome uae , 102.0 72 36

* Given a preliminary tuberculin test December 7, 1892.

61

Temperature as taken before and after the injection of tuberculin—Continued.

| 305 X | 306*
| Feb. 1-2. Feb. 2-3. Feb. 1-2. Feb. 2-3.
| Before injection. | After ni Before injection. After injection.
Hour. ees Peis << a. ae | 2 Feet | a
2) 5 Ba! 20 | a s= = 2) ay | AD (I =) a Be
Pee | a ee) £2 | a |2g) be 2/38 Bd 58
ay s | or 5 — Ss or | i) i is} or or =) or
a a | 7 Sa ee aS a oF a Aa fs
OF ite aeaeeremne 99.4 |.-.22- esse ) HOG) Ja ONS 100, essa ae 107.6) 50} 30
Mae eso CON Meas ee Wecieoy eet saly on. | 2000G0|s eee: er oe \ESdODeS {=e 5aclaee 2
Ti keigi tee Seer | 100.4}; 42 | 2) 101.6) 48 18} 100!4) 50) 16) 102.1) 42 18
(2imoon\ss-222. 5+ T00;4 | 42). 12) “100 | 42 15 | 100.6) 44|- 18] 100.8| 42) 21
GpaMineee cae Soe HOURS Hee Cala on O07 Sele donle TO 540). 20) 100s4 45 18
pipers s lace 101.0, 48 18} 101.2 48 18} 101.2) 50 26; 101.0] 45 21
Sips eee fa soe 101.8, 70 30} 101.2 45} 21) 101.9 | 66 36 | 101.8 | 48; 21
ASN ero 101.8; 78 30) 102.1 TENS) TO a0) eRe || SK)
Dip MUesee ss ces =- 101.4 66 24/5 10258} 75 30:| 1014] 62 24) 102.2 72 36
(37 Oat Os Aare 101:2| 51 24 102.0 54 24} 101.1 54 36 | 102.2] 54 24
7 yoilese anaes 101.3 Sone OTe Ss Saye |e TOONS 54} 28) 102.0 pa | 24
Sips see sss5. 100.7 54) 24) 101.6! 60 21} 100.9 54 | OO 1) 7
Opeinees aces... FOO} 50) 30) 00:6} 54) 18) 100!G 5) BY) |) 0 GG 36
HOMpemessseses = 1010} 54) 26] 101.0; 54; 18; 1100/8) 48 30 106.4 72 33
Spee Sees LOOM ot 20M mT OIMON = 545)h ssa 10088) 665) = 305) L06NO) |) 75 | 133
12 midnight...-.. 101.9 | 48! 20! 101.6 48} 15, 1008] 48 32 | 105.8 60-30
Lens heen WOU0} 48} 24) 1012 51 | 18; 100.9 48 24 | 104.4 72 48
DGG Goce eee 1G) SB OOS als HOI) |) 53 30; 103.4) 60 42
DET See eeeeeee 100.8 | 57 241 1012 | 60 24! 100.7 48 24 | 103.5 63 | 39
ALPS ewe sesoaten WOL4 | 54) 24) 101.2} 54) 15/ 100.8) 48| 24) 103.8) ° G3| 33
5 gn. ee auPeae TOM Qe 54 208) 10Te 0 57 20 | 101.3 54 PEN ORT GB) BO
Giantess cea 101.8 54 18 101.2 me | AIRS! TOL | 2 Di | WEST it GB). BB
pastuPsee sok 101-7) 54 21 101.4] 54 12} 102.1 54 21] 103.4) 72 | 30
Slasiner cess | 101.8 | 48 an 101k 5) | - 54 18 | 102:2| 48 24 | 03/1 Cour
2) Gg sce aaseancel ey bly tuberculin Ss. 101.5 54 18 | Inj. eubercul me Ss. | 102.6 60 | 42
10) 2). i see Sal lees eee ee ae 101. 0 48 Ta DA eee ale ie | 101.8 | Be
iI De This Se Re ane oe eae meme Dinisepielas eel OORSH Pam Sul tmenl Ouiece este evar as ler ale VeOne Tle 054i 87-30
U2) ACO ESBee Ae ee ae eee ieee ane | 100.3 54 MBN Baie cleo acl ere | 101. 2 54 36
il [D. Til. 3a555eeuee| Soneaeee Renee Eee | 100.7 AG aI As Tish wcotenre Uae |e cios== 101.0) 54; 36
2 De Wc qed seoees peeeene Beseee) aeeae WeeLOUROL G5, eB wie se ING Eee le aeee. 101,2 48 32
3) TPT oes keece | aetna Meeetnen [eee | 101.6 78 BY itis Ati eh eter tere 101.8 64 36
AFD SG saaeeeee aca etee Denes Reames | 102. 0 TERIOR SED lee Ge eete Hee ame | 102.0! 66 42
1 i i \
30 308
Feb. 1-2. | Feb. 2-3. Feb. 1-2 Feb. 2-3.
Before injection. | After injection. Before injection After injection:
Hour. aa 3 2 = Ren: an :
ro) . I ¢ : H Og : A} o Po ea
Seca hees a eit ee, | ie i Bi |e Be RS
aes Pee eal eae ei) Bet | Bus wal | RR | es ra | es
S| Brae a4 a | x Panpal esi aileed ao
fant eases aes IIE) Geeta eee 101.9 54 OF |e AE easc eal lessee | 101.6] 48) 24
UD Bio TM se eisenecee | LUE eee Sealicnesec| alia Cone Que Ol Ss |aanee ota se= | 101.4 48 | 21
lil Cian ae ee So oees } £01 2) 148) a2 Ome 7 42 18} 101:3| 48 TAM O20 ee SON nals
AMOOTe S22 2222-2. POM OM ste a Cher OIN he 48)) egardOtOU AS STAs Total g42 Hl) 18
Iq isie. sees ae | 101.4 50 18'| 101.0 45 15 | 101.0 44 18 | 101.1 42} 15
eee | 101.5; 48 18 | 101.3) 51 18} 101.2 42 16} 101.1 42 15
3 [to ceesoceaae iF 10252)) G6)" 32.) 10250 48) 21} 102)2)) G0) 30) Woz 48 21
L[PsiPssssesssecs) MORAE |) Ge) 36 | 102-4 | 78 36 |. 102.3) - 66 30 | 102.7 60} 24
2 [deh sstscecee 101.8 54 30 | 103.0 66 24 | 102.2 54 30} 102.6 60 | 24
GipsmeGin sie. 101.4} 54; 30] 1042! 60 18 101.8 48 Bib | TIER) || BI
0 1Ds ih cee Seen 1ol.4 | 50) 22) 105.6 72 36 | 101.6 48 22 104.6 BPA Wi Pall
&) TO sea ees ees | 1007) 54) 30)} 2106/6 72 24 | 101.6, 44 22) 104.6 54 | 21
J [pb Wese eos ose 101.0 50' 30) 107.6 CHa oT el Oleel 48 20 | 104.4 60; 2
POWs eS. vse. 104) 48) 30} 107.2 90) 380] 101:8} 48 20 | 104.2 54 24
gain = 101.0) 501 27) 1070| 81) 36| 1018| So) 24) 104.2) 48] 36
2midnight..._.. 101.5) 5£) 30; 107.0 Bj BL WO 54 24) 103.6 48 24
NG aN ns eet | 101.4) 48 26 106.7 78 36 | 101.8 4 24 | 102.9 o4 21
PANS ON eee oee eet = 101.4 54 30; 106.2 66 30} 101.8) 48 21 | 1038.5 66 24
VMN i Seay eE 101.4) 54 27 | 106.6 72; 42) 101.4 48 24 | 102.0 48 36
Abani OY ete ee 100. 8 48 24 105.8 68 30} 101.4) 48 24 | 102.5 54 33
5a.m- 101.8 | 54 24! 105.6 66) 42) 101.7 54) 80) } 10159 60 34
GieusaM Ayo sees 101.8 54! 18 104.6 60 27 «103.6 40 24) 101.5 45 24
gctemnesie eet 1022) 48) a8} 104.8 64 30 | 101:6 45 21} 101.0 48 | 20
Sraemiaes oe oie 102.2 48; 18 103.5 66 39 | 102.0 48 21} 101.0 48 20
O Gis eo Inj. tuberenlin §. 103. 6 66 36 | Inj. tuberculin 8S. 101.1 48 21
TiO) EGA eer ere marta ty kena al be Lae 102. 4 60 Ci) eeeeros jioehonse [eee yar 101.0 48 | 21
MBER ee <p oisae el am se = SIR eR CN SE Se 101.8 54. DES Sn act Saeco essa 101.2 48 | 21
LATA OS ve Rae eer (Ps eens ee Tee VR ea 101. 2 FE ley NERS ee Ee se 101.0 60 30
He pamioce ooo sa 2 ek ee eee 101.4 54 Be eevee Reese Bese oe 100.7 42 18
2D TUES in pase eas Al CA eee ihe Ca REE se 101.4 54 OYE We See ee eaten eaten 101.0 48 21
GDS: foe tea oe tela s MA emma Serge 102.2 66 oi tel Pesan beeen eemeag| 102. 0 60 32
Tae Une le MS Seal a eS eae BeBe a 102: 4 60 SOR tara a os eee tk) 8 66 36

* Given a preliminary tuberculin test December

7, 1892.

62
Temperature us taken before and after the injection of tuberculin—Continued.
309 310
Feb. 1-2. Feb. 2-3. Feb. 1-2. Feb. 2-3.
Before injection. After injection. Before injection. | After injection.
Hour. | ; is aa aoa hae ae = ; of | i a
a : x ' 3 p | \
| 3 J H fo BH a
| 23 | g |Se) Bo | ¢ |fe] 86 = | Se4eeon ee
| gs | 2,33) gh) BRS) ga) 25 oe ee
oe OS. 5 or or 5 or or = or or 5 ow
= a |e | a a& je | a A jm | | | ee
| | i
re et eee gers 100,47 | s renltee ene | 101.0] 42{ 18] 100.0 |...---|.----- | 102.4] 70 21
TOjAsan Seer eee ee IF 100 40:\|Seeee vee ee | 101.5 | 48 ABASIC OA Son eeelceeee | 102.8 60 24
IMB ae eeeessses) | 02 42 12°, 101-5 | 45 | 91 |= 100:8'| 44))) Sat Sapo aa 18
GOS see eee | 101.0] 42 12 | 101.0} 42) 15] 100.8] 42] 14] 102.0} ~60 15
Ihiaitec ns caee see 101.0} 48]. 12} 101.2} 36) 15) 101.2 54| 15) 102.2} 60 15
Dapemyse ae te eee 101.0] 42 12 Ole 45 15 | 101.2 48; 15| 102.4] 54 15
Sau Ss fon ances 100.8] 66] 30] 101.5) 42 18 | 102.0 72; 28] 1024] 60 18
7 pp 1 eS eee 101.7 66 30 | “102.3 | 66 30 | 102.2 75°| - 28-]— 10k I) age 24
yiyuneseaetecodel. siphe! 56| 30] 102.21 60 27 | 102.0 72 | 28 | 104.1 |=
Gaye aneiey see ee 102.0} 56) 24] 103.0] 60 30) 101.5 60 |. 28 | “10508 901 BA
i iviiieebeoas gael 101.8; 48) 24] 104.6 54 15 101.6 66 28 | 105.2] 84 18
Sipim.--. 22s) LOLS8 yl) 48h 2208) SteaNe cs i60 Pity Ae 66 | 24 | “105:6)-" 75 ees
Oapenie ny. secre 101.4; 42] 24/ 104.8) 72) 30| 101.4 66 | 24} 104.8) 78 21
LHS) (8 eS ae | 101.8; 42 30 | 103.8 63 24 | 101.6 66 | 24) 104.2 i 26
UM pe eae podoee 101.6} 48] 24; 104.2 48 24; 101.6 60} 20) 104.0 96 | 24
12 midnight... ---| 101.8 42 24) 104.0 54; 21) 101.8 | 54 | 26] 103.8 78 | 27
lame scene eh ee | 102.0 48 | 211 104.2 | 48) 20) 101.8; 70 |. 24°) S1035o" sees aces
Drag Soe 101.7} 60 27| 103.6| 60/ 27) 102.0} 66} 24] 103.2 66 18
Biaaitl seo. cope 102.3}; 54| 24] 104.0) 54] 30) 102.0] 66) 32) 103.7 63 24
LER eee aera! 101.8| 54] 24] 108.1]; 54} 24|) 101.8! 66) 24] 103.1 69} 21
Dia suena eee ee 102. 2 48 | 20] 103.6] 60] 22] 101.4! 62 24) 102.8) 78; 24
Baan ee oeeee 102. 2 48} 18) 103.0} 78} 2% | 102.0; 60 21 | 102;2 | 72 21
Teele oe eee 1052 Asie DL) 102.5ul Sari e| mln eee |. eee ee ee ee
IS Gls WM sees 38 | 101.2] 48] 18] 102.0] 51) 18] 102:8| 72| 24) 101-8) 66 20
Oe ha leBeorecnaan Inj. tuberculin 8. 101.8; 48) 24] Inj. tuberculin S. |-..-----)--..--|)-. 22
Ona. (afoot oe ene aease ieee 1OD;S)|, 24816 Wasa eee [school eee 100.4) 54 15
Ie gee ed eed cakes: leaders [eels RODEO tn eon eee | io .oe|s ncn culeceetees eee aaa
TO MOGIe st ee eee eee Mecpie 101.4. | 42) ean eee oe S22 ees eee 100.6 | 60 18
Das. 0: Be cieellele ee ree aseeae Nees 100. 8 48 ileal eaters ine lcam- =| <Seaee 100. 4 60 18
Dptmsetee ee Rea ens oe bees TOTNO0e 2 A80 eral eee nee RE EE tc
By) cnc eeanee: Sa aae Pcaeare fall ee f [aeaSee 10S 83)" 5272) BOM eee eee |. 2ot|se cee eee
apie asec ses eee ibe eee erase | SAO210%) S664): SS Gwle eee ne | wedcct| coos: eee ee Jreze0-
| | 3
|
311* 312
Mar. 15-16. Mar. 16-17. Mar. 15-16. Mar. 16-17.
Before injection. After injection. Before injection. After injection.
Hour. , lage? Seal a j aan Ce ae
fH | 2 |es| FE | 2 BS) we | 8 | B8| Be | 8 | ee
o- = COR Male cole [be Ere |p ess SB Ir ye! or or s or
a On Wf = ae: = dy | pa ees a |
| | | | | | |
Oa. mie chest ae 100.0 48 18} 101.0; 42 15! 100.0} 48 12| 101.8] 54 | 21
10 Aas Seem ee 100.2} 48 18 | 101.0 | 42 18 99.8 48 15 | 101.7 60} 21
Pda pesos cee 100.2 | 48 5} 100.2} 40 18 | 100,47) 157 18 | 160;4), 60) eee
ipinoome ss eeseees 100.2! 51 18} 100.4} 40 18, 100,4| 54 18); 1004! 60: 65
Lipase sen | 300.2 | 48 18 100.4) 42 15 | 101.2| 54 18 | 101.27). 60} aaa
Dipamiase oe meee 100.4 | 48 18 | 100.4] 48 18 | 101.8 72 21; 102)2)) = 603)men
Sepuntses over ee 101.0 66 24} 100.41 66] 24] 102:6) 78 | 36. | MOps4c)\ Sheen
Asati eae aes. ac 102:0 | 60 24 | 10L.1/ 66; 24| 103.0) 69) 307 10492)” Goo
Spann eles ees 102.4 | 54 24; 102.8] 84) 21; 102.4 66, 24} 103.8] 84] BB
6 pemeseeee eres 101.8 48 21 | 104.0] 60] 18] 102.0; 60 27 | 105.2; | ~ *S0) aan
MAPA ost a nema 101.5 | 44] 20} 104.4) 60 20 101.8| 60 24' 104.8; 80; 24
B ps eseeer ee 101.6 48 20 105.0 66} 27,| L085 | 956 30 | 104.3) 68) 30
Ops west ceee 101. 2 5d heey SLOGsO) mere 24} 101.4] 60} 24) 104.2) 80 30
{Opens Seeee a LOE 48 24; 106.2] 72 21, 101.6} 60} 24| 103,8) 72; 28
[Mp reso ee eee 101.5 60 20 | 106.6] 63 26 | 101.5] 56! 28] 1038) 72 24
12 midnight... -. 100.6 56 2A) 06.301 ae 24.) 100:8| 68 | 24) 10457 | S78 inuees
dase ee 100. 4 60 24] 106.2| 60 94 | 101.6] 56); 20] 1046) 7S) sae
Dia. Tine ae) eee 100. 6 56} 20] 1054] 66] ~27! 1018) 66, 24) 10ae 2 | 33
BFP un Net es eae 1.1008 | 60} - 24.) 105.1) -63,)) 2 2i) 1OIP8 ; 56) “18s 04s eae ree 21
AL iy Wiebe 2 cers | 100.8! 44 24] 104.2) 68 21) 101.6; G0, 241) 10458) 78 em
nse Bere Roe eas | 101.0 44| 24) 104.6) 60] 20] 102.0 60 |- 20] 104.8) 66) 922
Gianemieeeee rae ee | 100.6 | 48| 18] 104.6] 60) 21; 102.2] 60] 20) 10464 84) jam
Bianeaa ae ero | 101.0! 44 18 | 103.0; 54 21/ 102.4] 52] 20] 1042) 94 21
98s Meets ose ktee Injesibercolin 52.) -peeee a eee eee Inj. tuberculin |S. |----.--)sesen- fees i
AO amie © een eee en ome [ees (O14 RGONG BIS Pe eee eee (Stes 103.0 | 76 20
J? MOO se. see oe Sere rong | 452 Shea see ORES G64 ol ele et. soe eens Weasaee 102.8 72 24
Dip ani oes Boe Ae tte lee 100; 85,10 pO ie oso .\eee eel eee 102.8)" 92} 20

* Given a preliminary tuberculin test December 7, 1892.

63

Temperature as taken before and after the injection of tuberculin—Continued.

| 313 314*
Mar. 15-16. Mar. 16-17. Mar. 15-16. Mar. 16-17.
| Before injection. | After injection. Before injection. After injection.
Hour, | | Se
| | ; | oo ' | “
Pepe eee este | B. |B Seal Bice visit | ce
Lee | 2 ee 22 | 2 138) 28 | s es) Ge | 8 les
| of | B | oe] oF Bo) Sse ess MOR t One Sino
Peele eer |e Goo |e tem re ci le pete ay era ee
| | | |
9a.m.....-..--.| 99.6) 54 1s} 101.8!) 60 | 24 99.0 60 14} 102.0) 54] 21
TOVaSMe se aoe a 99. 4 48 18} 101.8 60 21 99.0; 60 14} 102.0 66 | 24
AM AmaMMee ee eee sae 100. 0 60 18 | 100.6 60 18 99.8 | 48 18} 101.2 66 | 18
12 noon .......--. 100.4, 54 18 | 100.8) 60) 18] 100.5; 54 21 100.8) 66! 18
eM 20) ea 100.4; S54; 21 100.8 60 18} 101.0 54 21 101.3 54 | 21
Diem eee TON | GR) Bl) OA | GD TO) Ge Maa ye 24
SspRONss es aS | 102.0 72 | 33) 102.2 72; 301] 102.0 78 33 | 102.4, 72) 24
“Js WS oopoasa sos 102.3} 72, 30) 102.6 84 30°} 102.2 66 33} 1038.4 | 72 | 30
Die UNG Soasdeusee 102.1 66 30 | 103.1 66 21} 102.0 66 30 | 103.0) 60) 21
(DO TNs osasssooos 102. 0 12 30 | 103.1 66 24] 102.2; 69 36 | 104.3) 68 | 24
Vit UN Se aeSB eee 102. 2 60 24, 104.6 72 24; 102.0 66 28 105.4} 72 | 24
Spams cers 29. 101.6) 68] 28| 105.2) 72] 24] 1020] 60| 32) 105.8) 94| 24
O05 Ne SS ap Seeeee 102.0; 68 24 =106.0 72 24) 101.8); 56 28) 107.0 | 72 30
WO 7Os Wh BSS sos Seos 101.5, +60 20 106.4 72 27} 101.4 60 24) 106.8 75 33
SIG pEgMniser-e eis == 101.8! 64 30 | 106.6 75 26} 101.5; 60 24) 106.6 72 | 27
12 midnight...-.-. 101.4 64} 24, 106.0 84 30! 102.0) 56 20 | 106.0 72 | 24
Oy Ti SoepeHean 101.3 64 24) 106.4 72 | 24/ 101.5 56 24) 105.6 72 | 27
2p Its SaSU RES 101. 4 60 20 106.0 84 30 | 101.6 64 24 | 104.6 72) | 24
2 bis 1 oseaeeeaee 101.0; 72 24 | 105.8 84 30 101.5 72 18 | 105.0 78 | 30
leaner nica atid 101.2 60 18! 106.2 69 33 | 101.2 66 24 | 103.0 48 18
Gels ilsesnocusacs 101.5; 64 24 | 105.0 7. 24 102. 0 60 20 | 103.0 75 | 27
(Boise ésocsenus 101.4 60 18 | 105.2 66 24 | 102.2 66 24 | 102.6 | - 60 | 18
Gem eae 101.8] 56) 18 | 105.6) 63! 27] 102.6| 52| 20) 102.0) 66) 24
Garages ee 3/1 nj muberewlimisS: |Se=<.-c|- 22255) --2—— | Inj. tuberculin S. ......-. jensen ets
iMG) Gin ile a eee eee (steers Ne: HOLE op GD |p AD ese one pear aaa 100.8| 64 24
Hpinopne eee cls. eee ee aie j LOD C,| eNGSy sa ode EES ea ere 100.5 | 56; 18
il 7D; Whscoocecoccdloca speed lobeses||cuueed 102. 0 | 60 Be coSeoabollcsosse eo 100.8 | - 64 | 18
| |
315 316
| ie —— Reba a — — — ————
Mar.15-16. || Mar. 16-17. Mar.15-16. | Mar. 16-17.
Before injection. After injection. Betore injection. | After injection.
Hour. ; ] Ty | 5 5 7 Saag l aes ] | ae
I H z | os 70 a lo 2 4
a eed ecm ene Slee Eales aha esas | S
Be | 8 |e8| Se | 2 | es] s5 |-2 1e8| BE | € jae
Beis lee | SEs ise i ge |e | es) BS is ies
Sab it sles San ISS a | FA a a) AS Bh Bap ies
| | | | |
| | | | | | |
UI ciei aren cel 98.6, 54|/ 18) 101.8 57 | 24] 101.3 60 12 101.4 60 16
W0a.m..--....s..| 98.8|)* 48|} -15} 101.6| 57) 24] 101.4! 60 18 | 101.4 60 | 16
mbar ns Pee) | 99.4) 54 18; 101.2, 57 24! 101.6 60; 18) 100.6; 60} 18
12 noon ...-...-.. 99.8; 54); 18] 100.8! 57), 21 101.8 60 18 | 101.0; 60.| 2]
bj hun ssSeeesese 100.0 | 54 18 | 101.2 48 24] 101.6 60/ 18] 101.3) 54 | 18
Ohpamese ee 3 cs 101.2! 60) 18; 101.6 60, 30] 101.6) 66| 24) 101.4 63) 21
SMPoMM soe = eS ee 102. 0 66 30 | 102.6; 84) 30 102. 2 78 24 101.6 | 78) 30
215) 0) 00 eee te ee 102. 2 60 27 102.6 60 27 | 102.6 72 27 | 102.4) 78 27
By ee ane TOPEAG Ee RGON aE oO: | TODS24 | ¢ c607 en 24) | 10m4e lee 78) i 24) 1080) 78) 30
Gsprmase es Sas 8 2 102. 0 60 30 103.8; 76 21 101.5 72 27} 102.6] 76 28
ag spliNet Siete las te 101.6 60 28) 104.5) 60 24} 101.4 66 24 | 103.2 80 | 24
SED Safes Gh 101.8 64 82) 105.6) 84 24] 101.6 60; 24; 103.7) 72 | 20
hp ems epee 102.0 56, 24) 106.8 75 27 101.4 64 24 105.3 72 | 20
IQ) jp eae eeseede 101.8 60 | 24); 106.2 84, 24) 101.2 60; 20 105.9 72 | 24
iil TOSS ee eooeaes 102. 0 60 20; 106.2); 72 24] 101.5 60 | 24) 106.2 | 84) 24
12 midnight.-....- 101.2 56 28 105. 6 Ub i Pts} 100.8 64; 30; 106.0] 72) 33
Ts Tee eee 101.6 56) 24); 105.8 66 21! 100.8 60 20} 105.4) 72 | 30
PREV AU Ne l)ayola)=t'=|=/alo%e 101.5; 56; 24) 105.6) 78 27°) 101.3 G4 18 | 105.2) 72 | 30
Sade ee ee cee ~101.8{ 60; 24! 105.6) 72} 21) 101.0} 56) 20} 105.0; 88 33
AP Os AMRE Ss alae shore 101.8 57 24 | 105.0; 60 20, 100.8 56 24) 104.8) 84 24
Hele a Seo ssaas 102.0 60 20 | 104.0 72 24 101.8 64 18} 103.2-| 72 | 30
Glamis e seria 101.8 60 20) 104.0 72 22) 101.5 60 18} 102.8 | 72) 27
Sas mies eae 101.8 56 | 20] 103.5 60 21 | 101. 4 64 16) 102.7) 78 | 24
Cini ssncosoedos Inj. tuberculin 8. |..--.--. Ieeneoe [segs Inj. tuberculin 8. |.--....-. Gece ees eat
10) O70) Sessas cea cclbesoteou\lsasecs laser beaie 102. 2 BG ad eter. pede |scoaee | 101.8 72 18
IY) WOOD -saenesosdlessoscssoscoas Ivinrers 101.8 56 24e See a [eee = letserstere 102.5 66 18
IDs seeedasoedoooqucedlacueas eases 101.6 56 Be soascsoe Bose |eeeees | 102.3.) 64 24
| i] 1 t J

*Given a preliminary tuberculin test December 7, 1892.

64

Temperature as taken before and after the injection of tuberculin—Continued.

317 | 318
Mar. 15-16. Mar. 16-17. Mar. 15-16. | Mar. 16-17.
Before injection. | After injection. Before injection. | After injection.
5 ] aa | ]

3 2 2 hikes ee] eee hes mans

Hour. 5 | | I = ale bee =| eo f=!

2 ==) 2 eee 3S = 2 jee

AD! | | 8 a | 3 A “Ss or] aes i 3

@ ef a= co) ay oN eck ) 5 et eal 2 Paes (nS

e | 8 | By) gf |B. Be | 8 oe |e | ae

=| 5 1a | a eee = D = in Bee fa

© [= Hea eae 2 SE Oi Nhe eo =) o ) | # o

a a | aH | & | dH Aw a a A |

| | | | |
Grasmere cea er 101.0] 42 12} 101.7 | 48} 18] 98.8} 48 15 | 102.5} 66 21
JO parma aS meee e | 100.0} 42) 15] 101.6} 45 | 15] 98.6} 60 | 159)" 10272 see nar 15
Uta.inecs-2-2 eee 100.8} 42/ 15] 101.8} 39) 15] 99.0) 60; 15} 101.6) 60 15
1p naonesee ees 100.8] 42 15 | 101.4 39 15 | 99.4 54| 15 |. 1014) 5d 15
psa st . seece 100.8 | 39 12| 101.4 | 39 12} 100.0; 54] 18] 101.6} 54 18
21): Messe saa 101.3 2). 15 |: 202.0) 651 :|) 15)!" 100.2) | 2/54" | = Sa beta meme 24
Sp iaveet 3s ees | 102.0] 54 24.| 102.0) 66). 27! 101.4 72 |. 24] 108501) anne 30
Atpiqtiecesie = eee 10256) |) «60 1) 245) 1O256s pare 24 | 102.7 | 72.) 24" SOND alana 24
Bipsm-4 sesesemse 103.0'| 66} 24-) 102:07 72°] 21 | 102)8:|° 72) |) 227 Shee ee 21
6pm | 102.4} 60 | 20:) 102.2} 66 |)> 24)) 2030.1) 60 | sya aelOGabae 20
pam eee eles) ODA On pumas 20) 103.4] 56! 16] 102.4) 66) 24) 1074) 946 24
8 pi Meee see 102.0} 48 24| 103.5) 64 18| 102.0} 60] 24] 107.2} 7% 27
Oipimisaet ss loa 102.0 | -48] 20) 104.5) 66) 181! 102.2 | 60 |) 245) = ativaOhime 24
10pm eee | 102.2} 44] 24) 105.4] 69 18} 102.0; 56) 18) 106.4] 78 24
Dap hn sce eee 102. 0 56| 24! 105.4 66 | 21.) 102.0] 60} +20 )» mOGraal = ae 27
12 midnight...--. 101.8; 48 16; 105.6} 60) 18} 101.6] 64 20! 105.4 | 84 24
vas meeee Saeeee |) 5102.09) SaGOs ge dy) Ob del dere 18} 401.4/¥56| 24| 106.2] 78 27
Dlaninern clear 101.7 | 144] 290) 105.6] 78 22.) 102.2] 52) 18.) “106/00 eee
Basile sei | 101.8] 56 18:| 105.8} 72 | - 21.) 101.6 | 56 | eis) eit ere 30
Asda gee eae 102.0) 54 18 |-104.8; 75 | 92) 101-5.| 60} 24) HO5.05) meee 30
Biaatincs sence | 102.0) 40 18.| 104.8} 66 | 18) 102.0] 60 18 | 105.0] 78 27
Grae eee soe 101.8 | 44 18 | 104.4.) 60°) 21 |" 109,27) "725 220m) eae amen 27
Sa Dice se eee 101.8}, 44] 45) 304.2) 51) 21) 103595) 160) |0, Sal eOneee mae 24
Oa Mize: Sas ee Inj. tuberculin S. |-----..- \Gaaaae {eee | Inj.tuberculin S2 bse 9-ees=eee eee
LOta Mie Sauee Belen eee hee ee pesos 103.0 | 60 | TNs ieee (phones 103.2 | 64 24
(2 noon=-2=2se 55018 ie sree he ceencsed Sie Sete 102. 2 52 “vb Silasce -aee| asc ee lees 103. 2 66 20
I EC Sopokbods for secn4 Beoade jeer 102.4 60) 18 |.--..--.)----+- +--+. 102. 6 72 18
| | | | \
/ |
319 X | 320
Mar. 15-16. Mar. 16-17. Mar. 15-16. Mar. 16-17.

Before injection. After injection. -| Before injection. After injection.

ee z Sele apne: 4°) Gea z

Fe) = =) 1S 2 < ia BS)

z = s = 5 | & et &

Z Pam 0 Bea > | & | Blige) Bel

fe | Bg | BB | 2 ene

o =} 2) ® =} ® D I} o D eee |S.

a py en = ay a a Be | & | Be

| | |

DENG res see 2 oe 99.8} 48 18 | 102.0} 60 15 98.8, 60 12: )) 10128.) Saas
HOM. fitesene eens 99.5! 66 18 102.0 47 15} 99.4 66 | 12} 101.2)) So 12
ie ies ee 99.0) 60| 15! 101.0; 60/ 15| 99.0] 54] 12] 100.0) 48 12
12 Noone eon aeee 100.8} 54} 15} 100.8] 54 15| 99.4] ‘54 12 99.8 48 12
Tpniegihet ceo eens 101.4 | 54) 15 | “101.0 48 15 | 100.4] 54 12°} = 999) |) om 12
Diptree oe eee 10106 | - 48: | 954) tons 57 | 18} 100.3] 60} 15} 100.2) 57 15
SpWniee aol esos 102. 0 60 | 24} 102.2 60 | © 21 | 100.8 | *=78)) > 300) SOR OninGo 24
Apmis 5:0 400 103.0] 66) 24) 102.7 GO! S21 | 102n0 Sars 24! 102.0} 72 24
ipa cee 103. 3 66} 24] 101.0] 66) 21} 102.6) 63 | 249) “JOTRON ngG 21
Gps eae LOSSIS soi), Malet eel Oe 60 20°), 10222 69 | 15.) DORTGN a: 366 18
Ups we eeae 102.2 | 60} 20 102.3) 60] © 16) 102.0} 60} 18) }: 202s0n)eerGo 20
Spence ec. See es 103.0} 56] 16] 102.5 54 14°} 101.5 | 52.) 163) 910275.) 72a ees
Oipi Meese ee 103. 1 52) || ©1248! MORSS 2 t630 eben Oe 60°| 24) 103527) 260s saa2e
1Ospameeee oes | 102.5] 60] 20] 102.6} 63] 18] 101.6] 60| 24) 103.6) 60 15
Ail sp. sri eee 102.5} 60) 20}. 102.8] 54] 18] 1015} 60] 20) 1042) 66 12
12 midnight. -.--- 102.4 | 56 1G? | DOT S82): 668 | Sere) es Loe 56). 16] 10472))> 66m 15
Aa aes SO 101.8) 60 20'| 101.8) 54] 15 | 101.2] 64) 16) 103,610 5% 18
Dian meres a: pas | 102. 0 | 64} 18 | 1022] 57) 18 | 101.0} 56| 24] 103.2] 60 15
Sacmes2 2420.4 102.0 60 18} 101.6] 54] -15| 101.2] 60] 924] 102/78) 60 18
Ais mpc see 102.2 |: -54%)---24-}- 102.0} 972.) 38°} 101.5] 56 18.|', 102765) seam 21
Sige ee a eo 101.8; 56} 24) 101.8] 60 15 | 101.4.) .-60.|. -15-| 102/23) Ghee
Ghat nee ee Eee 101.8 60 18 | 101.5 60 15 | 101.5.| ..66 | 24-| 102°5.) SG6nieeets
a See eee 102.5 | 56 16} 1006) 54) 15 | 101.6)|> 48 le S185 oie aieay 15
Gasmy<sas0- iS. Inj. tuberculin S. Joos 2-2. Seetee feeatent Inj. tuberculin S> |----.--- RAE Sol [Sac - = -
LO sean Sects phew Peer. (ee ree P02, 0-(/ 5 aesi\! We a eee? ecure weaes 101.2. | 258 16
TD moors ee ees oe ae | eal ae ams Vleck Romer 8] ema ce hE ieeeaes| ees 101.5 | 48) is
Db iano 2 eae ates | ee ta eee le TOTES" 256" | aa |e eee ey Saas 101.,0°4_. (600) sen

65

Temperature as taken before and after the injection of tuberculin—Continued.

321

32

2

Mar. 15-16.
Before injection.

Mar. 16-17.
After injection.

|

Mar. 15-16.
Before injection.

Mar. 16-17.
After injection.

. : | 6 - 5
ee ek aS oe ie :
Be eel a 2 = S = =
Fa Boke = = Ee el pels =]
Bele lees ¢ 1H z. Sr Meee ot oe Foe) phic
5 Sino) 08 a ee ee“ ar a ae ge -Ga
| 3) = O:2"| 2) = ° 2) Sey © Far eh 3
/ oa g aa = es & a a ea x &
Qasr | 100.8} 48{ 15} 101.8; 44; 18] 99.6; 40; 42) 102.2) 48} 20
as mses ics cts ; 100.6} 5) 15! 101.6] 44) 12] 99:6) 42 12|| 102-0 |> 48) > 15
ibis ices eae | 1006} 48) 15 | 102} 54) 12) 1000] 42] 12) 991] 54) 48
TIMOON «as! s-==-- 100245] = 482| > 15 4- 100:9)| 51) = 12 | 100.2 | * 42 1-121 99.0) 51) - 45
ipamiscsees soo: OOS a ese at = 100) 8h) i} 127 10085 | 425) 12 9956 || = 4a is a5
Deets a Sse WOOs | 54) 915} YOU] 48) 15 | 100-4) 48] 18) 99.8) 54 18
Dyess pees Te ee GON ome te a LODO N66 | 2d |e 10186 a 541 22 1 1010 1 G6 is oT
Mopars se. 2 1008 | 60} 241 fo22) 54) 24) Tova} 54) 24; DO12] 54] 21
Ripa Sees ane 102.0} 57{ 24) 101.2; 5£| 18! 1022} 54] 24) 101.0! 60} 21
Gipsmeeee te ee 10225)5 bf) 18) 10l.6)- 52) 15) 102)3 | 54) 21 | 100.8 | 60} 20
fips Mises Seebas =e 1020 | 54) 18| W018) 48! 16) 1024) > 54} 21 | 101.4) 60 15
Sipe es on = WOTECeenGt a e20 i 10K Gale 60. 12) 10290) 2 525) 2051) 0018) | 52 |= ae
Opemmeeeecens ia: 1020. | 60°} 20; 40252) GO} 18] 1025) 56) 24] 1022) 68| 20
POnpewaee see - ace T0i8 | = 60} 24) 1030) 60) 18} 1020) 48} 24) 1028) 54 18
kgpaansee S25 102;0| 60} 20); 103.4) 48; 18) 102:0}) 56; 20) 103.0} 54 18
12 midnight...--- 102.0) 60} 12+ 1063.3 | 571-18) 101-8) 48 |) 16) 1024) 54 18
MEN RG SARE SERCO eetiye | 18 |. 10252 |= 52) 16), 10350 | 957 | is
Ee 684 18eb 10350:| 2 45 (ect -100.8 9. 48'} 16), 403:0)|), 54) 4-15
See G0r) Se) 02 6-b 48-12 185). 10188) 56-1 218 | 1035012 58 15
A | 52) 24) 1024). 51} 18} 1022) 54] 18] 1026) 48 12
POs OD elaalSe| OSs 154 1 “18t1— 102.0) G0); = 18 | 1025 | 544 2
6) 56, 20) 1020 54) 18] 102.0) 48 US) 02s 5d iS
Pps -42( 320)) 101.8) 48) 2 | 1099" 4g) 12 | 102/81) 54 12
jestmberculinis: [es sie asso 22 - | a2 Inj. tuberculin S. |.--..--- eesecl Goose
eA. pees ete pte re (ier coast ee bees | 1016 9) 2152 12
BISA teoe bens eaten | ROTRG Hl ae60) Reel Silo Sepia ee ee | 101.8 | 48 15
Seco a Sl See, eae ae 102. 0 a ae ee ee 101.2 56 18
323 324
Mar. 15-16. Mar. 16-17. . Mar. 15-16. Mar. 16-17.
Before injection. After injection. Before injection. After injection.
. | } . - | . |
Hour. zg | ests =e = g a = ene
Bo] LORE as 2 Sel g & Ss
Dera prea aes 5 : = s : = 3 : £
fib eeche came tetas | pom velco Pm Be [eae ii)
LCs seers c=) ate) 5 = oi) 5 e} 2 S = 2
tks ase | Pe > aad koeh =e et a a} H oF a = A S
| | { | | |
Qasmecc2s-s252; O97-| ee DD e ae AD ts 10250) bh *.57 18} 401.0 }2 721° 21.) 102.6) “68 18
Des nice ee epee | 100.0} 48) 15| 102.0| 60| 18! 100.5! 66] 18| 1028] 66, 24
vase see s-22 32 10:2} 54; 18] 100.4| 60] 18! 1008] 72) 18) 1026] 66 21
HOmoonee es OOH S Sera iieeihoi 100841055574 = 1s 4 Ol Joe) = 18' | 10295 1 66 2i
lepine see oa 101.0| 48| 15) 101.4 | 57) 18; 101.5] G6) 18; 103.4) 66 24
DADE AA ee eee] MIG! ea GOG eetbce 101e2 | 160! (218. |) 101s 7 | 72) 24 fF 103.45 |. 72 24
Bipome eee soe 101 8} 272 239} 101.6 |. 66). 24) 102.9 | 84] 33 | 103.8} S4 30
ayemMme mesos TO2S9a eat | eT T0252) | 6621 240) 032) Si | 27+) 105:6))| 66 33
i peMicen te src | 103.5 | 72| 371 1025 feeGOspemo tate 10450) 78 i} = S0l) 05. 8 24
Gypnmnses tenes 2S 103.4] 60) 27) 103.5) 64 20 103.8) 72 EOS) = 12 24
Raper 2 sey. = | 10256 |-60! 94) 104.2) 72{ 20; 103.6] 72} 30; 104.6) 80 30
Sipsmiene- aasn 102;5| 64; > 20} 104.8) 721 18} 103.2] 66} 28! 103.0] 7 28
9 p.m.---- ete 102.4) 64! 28) 105.8) 60! 18! 103.0] GL} 24] 105.6) 80 30
ROUpeaM sees ps ee 102,24 56) - 24 | 105:8| 7! 21° 10315] 72] 32] 105.6] 90 24
TUL j Ogi ieee 102.2 60 20} 106.4) 7 Di eal0ss2, 64 24 | 105.4 909i 2
12 midnight. --..- 102.0] GO| 18}; 106.2; 841 24) 103.0] 60] 20; 1054] 90} 30
slPasenriess senso Se 101-8) 60} -20} 105.6) 7 241 103.4! 72! 20} 105.6} 84 30
DARI. oso sc 101.8] 60; 18} 106.0|- 72| 24] 103.0] 68] 24; 105.6| 84: 30
anes a te 101-61 64) 20) 105.4! 78| .18|-102,5! 801 24) 105.8! s4 30
TG hers aaeee eee 101.4 | 60) 24 | 105.2 | 87} 30} 103.2) 72) 24) 105.8| 84 30
RU lj ileeineoaeee 102:0} 60) 18] 104.6} 72) 30] 103.0) 80} 24) 105.6; 84 30
Gacinsssessecee: 102.0] 56} 24 | 103.8} 66) 24) 1028) 72 94; 1054] 84 30
SaeMesce se scos: 102.0'| 56 | 24] 1028] 66) 24] 102.8) 72) 18] 105.6| 84 30
Sanghlce 2. sen AP tUbercMline See: | aoe. c-=2| 22 -saatren = Inj. tuberculin 8. |...-.-.- lssosad Secs:
TAG yooae sees Preenenn see tees TOZRON Toe eee eee fo Meee ieseies | 104.5] 80/ 30
MO MOOTI ase eee. [asus see [Eames HO Tda GG |p Oy eee oaece ake | 103.0] 80 24
Tee een oendees aon lnel secu 2 TUTE eee Sea te Seems lice See! gem e- | 103.6 | 76 30
| | |

66

. a . . . a ®, - .
Temperature as taken before and after the injection of tuberculin—Continued.

Hour.

11 p.m

Hour. |

325 “HK

ees 21, Nee 22:
Before After
injection.| injection.
poe ices wi 100.7
101.8 | 101.2
101. 2 101.4
100.5 } 100. 0
99.4 100, 4
100. 2 100. 4
101.0 100. 6
101, 2 101.0
101.2 | 101.6
101.6 | 101.8
eer 102. 0
101. 4 101.6
102. 0 101.4
101.8 101.0
101.8 | 101.2 |
101.8 101.4
an ot Rare ee

329

Mar. 22.
After

Mar. 21.
Betore

‘injection. injection.
|.

-m™m

10 p.m
11 p.m
12 midnight

Se mee ene cot 106. 5
101.0 107. 2
100.6 107.5
100.8 105. 6
101. 0. 106. 0
100. 2 106. 0
101. 4 106. 0
101. 2 105. 4
102. 2 | 105. 8
102.8 105. 4

ee ey ee 106. 0
103.0 105. 0
102. 8 105. 4
102. 6 105.5
102. 4 | 105. 6
102.6 105, 4
109.4" |e:

333
| Mar. Qi) Whar 2.

Before | After
| injection. Injection.

ete ae 106. 0
101.2 106. 6
101.2 | 106.9
101.3 | 105. 0
101. 2 | 106. 0
101. 2 106. 6
101. 0 105. 8
101. 2 105. 0
101.6 104. 0
101.6 103. 8

102.8
101.6 | 103. 0
102. 0 103.4
101.6 103. 4
101.7 103. 0
101.8 102. Bt
101-91). - fee

B26 pie |
Mar. 21. | Mar. 22, ; Mar. 21. Mar. 22.
Before After Before After
injection. injection. Seca: ges coe sae
|
iocee cee LOE ane Sheects 102.4
102.2 101.9 103. 2 102. 4 |
102. 2 101.9 102. 8 102.5
100. 6 101.4 102. 5 102. 5 |
100. 2 101.5 103. 0 102.4
100. 8 101.5 102. 6 102. 2
100. 8 | 101.2 102, 4 102. 2
101.6 102. 0 102. 2 102. 2
101.6 102. 2 102.2 102.4
102.0 102.8 102.2 103. 4
Pee nee LOBED) 2 eeermees 103. 0
101.5 102. 4 102.0 102.4
101.6 102. 0 102. 4 102.5
102. 0 | 101.8 102. 6 102. 2
101.5 102.4 102.4 102.8
101. 6 101.8 102. 6 102. 6
TOL G Gates ee HOD See sien
Inj. tuberculin K. Inj. tubereulin K.

330
pines 21. | Mar. 20,
Before After
injection. pope see
sp tahiete Ee 101.8
100. 6 102. 2 |
100.8 102.7
100. 0 | 103. 2
101.0 105.0 |
100. 8 105. 8-
100. 4 105.8
101.6 105. 8
101.8 105. 6
102.0 105.5
Se Py 105.4
101.8 104. 4
102. 2 103. 6 .
102.0 | 103. 0 |
101. 2 | 104, 2 |
101.5 104. 6
RO, als cameras

Inj. tuberculin K.

eet 102. 0
100. 4 102. 4
99.8 103.2 |
99.5 104. 4 |
100. 6 | 104.9
100.2) 105.6
101.1 105. 8
101.0} 105.8 |

| 401.2 105. 6
101.6 105.8 |

lptece eres 106.2 |
102. 0 104.8
101.8 105. 0 |
101.8 105. 0 |
101.8 105. 0
101.4 105 6
101.2

328
Mam 21, Mar. 22
Before After

inj jection. injection
ee ee
| Deer } 102. 2
100. 2 | 102.6
98.8 103.4
99.5 102.6
100. 0 103. 4
99.5 104. 2
100. 5 104.2
101.4 103.4
101.4 103. 6
101.8 103. 6
outed 103.8
101.8 103. 0
102.0 102. 5
101.8 102, 0
101. 2 101.8
101.0 102.0
101. OQ. | 25 secre

Inj. tuberculin K,

332

| "Meare: 21,
| Refore

Mar. 22.
After
in Bjechion: oes

Inj. tuberculin K.

Mar. 22.
After

Mar. 21,
Before

injection, injection.

Pra Si 104.9
100.3 105.8
99.2) 106.4
LO 10h
101.2} 107-1
101.4 106. 6
101.9 106.2
102.4 | 105.8
102.3 106.3
We f= 106, 2
102. 4 105. 8
102. 4 106. 8
102. 0 106.5
101.8 106. 2
101. 8 105.8
101, 9)}s025, tee

Inj. tuberculin K.

cre 336
Se
Mar. 21. | Mar. 22. Mar. 21. | Mar. 22. | Mar. 21. | Mar. 22.
Before After Before | After Before | After
injection. injection. injection. injection. injection.) injection.
{
panes 102.2 |...:2..-.61 08) 0:)o25 eee
102. 2 102.6 100. 5 | 104.8 | 101.5 105. 6
101.4 102.5 100. 6 106. 2 | 101.2 103. 6
101.5 | 101.5 101.8 105, 2 101.0 103.4
100.8 | 102. 0 101.0 196. 4 | 101.0 103.2
100.0 | 102.6 100.8 108. 9 100, 2 104.2
101.4 | 102.5 101.2 106.6 | 100.6 | 104.3
101.6 ' 102. 5 101.1 106. 6 101.4 | 105. 4
102. 4 | 102.9 101.6 106. 0 102.0 105. 6
102. 2 102. 6 101.5 106.8 102.5 105.6
jetties Serna ge 102,53). = sae. 107.8. Seep ee 106. 0
101.8 |! 101.0 102.0 106.5 102.5 104.6
101.8 101.0 102. 0 107. 2 102.6 | . 104.6
101.2 | 102. 2 102. 2 107.8 = 101.6 | 104. 6
101.6 101.6 102. 0 107.2 101.5 104.0
101.4! 101.2 102. 0 107.0 102. 2 | 104. 2
TOLD by seers (al0T- Sikes eeene 102.2 7-545
Inj. tubereulin K. | Inj. tubereulin K.

67

Temperature as taken before and after the injection of tuberculin—Continued.

| 337 338) 339 | 340
Hour | Mar. 21. | Mar.22. | Mar.27. | Mar. 28. | Mar.27. | Mar. 28. | Mar. 27. | Mar. 28.
| Betore After Before After Before After Before After
injection. injection. |injection. accion: Heceon: injection. |injection. |injection.
aa NY Reps SEA iat pee re a Bes Hees Ss elles Bs [eee 2
|
Figen ee aera steel is de TODA 5 Wu crate Be Wen wel OOK Bs ler a Hane seek NOB Nee soe ssces 103. 0
Siamese eS 101. 0 102. 2 102. 2 103. 0 | 99.8 | 102. 0 99.9 102.5
Dhar eI bers Sates 101.0 103. 0 102. 2 103. 3 100.8 | 102. 4 99.9 103. 2
10 Bp Wessseassesase 100. 5 103. 0 103. 0 103. 6 | LOL. 2) | 103. 4 | 100.6 | 104.0
10 oes See eooeee 99.8 103.6 103. 2 | 103. 6 101.2 103. 6 | 101. 2 104. 0
QpMOOMe se ea 99.8 105. 0 103. 3 103. 2 101. 0 | 103. 4 | 101.0 103. 6
Tipo aoe Meee 100. 4 105. 0 108. 2 103. 2 100. 8 | 1038. 2 | 101.0 103. 6
Bio Wsseseecoadoss 101. 2 105.5 103.6 103. 2 | 100. 8 103.0 | 101.4 102.8
Sipemeasiwieeesses 101.2 105.2 | 103.6 103.4 | 101.3 103. 0 | 101.3 | 102. 6
450, Soa ne anocodae 101.4 105.5 103. 2 103. 6 | 101.4 102.8 | 101.6 102.6
Bide 1s Sees ee PS ee eae 105. 2 108. 2 103.0 | 102. 0 103. 0 | 101.6 102.6
Gyo ines eee 1022 | 1037 | 1026) t032| 101.3 | 1028) 101.2 102, 4
Tap aUlvnacisecset = 2 101.8 104. 0 102. 4 102.8 | 101. 4 ! 102. 8 | 101.0 | 102.0
Sell avescssooqoee 102.6 104. 2 101.6 101.8 | 101. 2 | 103. 2 100. 8 102. 2
Ppsemisissekesee- = 102. 0 104. 0 101. 6 101.8 | 101. 2 | 102.2 | 101.0 | 102.2
iv a 4 ssoddaeuonoos 101.8 103.8 101.7 101.6 101. 0 | 102.5 |. 100. 8 102.0
LE eee Sateen STNOSTES Gia ees ee napes 101. 6 | 101. 4 | 101.0 102. 2 | 101.0 | 101.8
1D Padnieut seeoses Inj. tuberculin K. | Inj. tuber culin K. | Inj. tuberculin K. Inj. tuberculin K.
341 342 343 344
Hour. Mar. 27. | Mar. 28. | Mar. 27. | Mar. 28. | Mar. 27. | Mar. 28. | Mar. 27. | Mar. 28.
Before After Before After Before After Before After
| injection.| injection. injection.) injection.|injection.|injection.|injection. injection.
= ese atl ih eet et ee _| a STS
Op ATMN s/Seh s Hes eae Beth ATSDR WiealleSieare aera | MOAR 2S So eee LOGE seers see 101.6
Reasmeyseyeeee os 101.0 103. 0 | 99. 6 104.8 100. 8 106.0 -99.8 101.7
() Nea ee i ean 101.8 103.8 100. 2 105.3 101.3 106.5 100. 0 102. 4
10) BRUT See eames 102. 0 104.0 | 100. 4 105.6}. 101.0 107.0 100. 4 104. 0
TEP 00 eee ee ee 102.0 105. 0 100.8 105.6 101. 2 106. 5 100. 8 104.8
12) noon. --.-5---:-- 101.8 104.7 100. 6 106. 0 101.0 | 106. 2 100. 6 105. 2
IL eae eA paar eae 102.1 104.8 100. 6 | 105. 8 100. 8 106. 0 191.0 105. 2
OMOUME Ree aeials ai 102. 0 104. 0 | 101. 0 | 105. 0 101: 0 105.0 100.8 104.1
& [Obie oadesouod 102. 2 103.8 101. 2 104.4 101. 2 | 105. 0 101.6 104. 4
LUT) 001s Mace a ee 102. 4 104. 4 | 101.5 105. 2 101. 6 | 105. 2 101.7 105.1
DMPA = cise Soe 102. 2 104.5 | 102: 2 105. 0 101. 4 104. 8 101.8 104. 6
GORMAN sso 26 ee ee 102.6 104.2 | 102. 0 104.5}, 101.2 | 104.5 | 101.5 104. 2
HBP EAM eisai skies 2 102. 6 104. 0 101.8 | 104. 8 101.3 | 104. 2 101.0 104.6
BAM eos tee ss! 102. 8 104.2 | 101.7 104. 0 101. 2 | 108. 6 101.5 103. 2
QO. i SAA See 103. 0 104. 4 102. 0 103.8 101. 2 | 102.8 101.2 103.2
LOM MMS see 102.5 104, 4 101.6 103. 2 101. 2 | 102.8 101.6 102.5
TAD Nas cee ae 102. 4 104.0 | 101.5 | 102.8 101.4 | 102.5 101. 4 102.0
12 midnight........ Inj. tuberculin K. | Inj. tuber culin K. | Inj. me anercnlin K. | Inj. tuberculin K.
|
| 345 346 347 348
Hour, Mar. 27. | Mar. 28. Tek oT. Mar. 28. Apr. 12. | Apr. 13. Apr.12. | Apr. 13
Before After Before After Betore After Before After
/injection.|injection. injechion: ale ction: a eCUO Hinde’ tion. dn ecuion: injection.
Uma eens pe terate ae | ees MN | NOE ON Avs Sates ie NOMS E Soap | NOD AGlei re Ber 101.8
GuavdMes je ciee esse 99.8 | 102.5 | 99. 4 | 101. 4 | 100. 6 | 102. 4 100. 2 | 101.6
O Means esis ofa A rac 100. 2 | 102.8 | 99. 4 | 101. 8 | 101.0 | 104; 2 | 100. 4 | 102.7
WOW AIM eee Shere 100. 2 | 104. 8 | 100. 2 | 102.8 | 101.1 | 105. 4 | 101.0 103. 6
NIVEA TEE ORR a eaneees 100. 8 | 105. 3 | 100.2 | 104.9 101.3 105. 6 | 101.0 | 104.8
12 noon..-.---:--.- 100. 6 | 106. 9 | 100.6 | 104.8 | 101. 4 | 105. 4 | 101.0 105.6
bass aye see 100.6 | 106.0 100. 6 104.6) 101.5) 105.8 101.4 105. 6
Qe ans ase eee 100. 4 | 105. 4 | 101.2 104.3 | 101.6 | 105.7 , 101.4 105. 2
BPP Msr a2 arate aie Se 101.2) | 105. 2 101. 4 104. 8 | 101. 6 | 105. 6 | 102. 0 105. 2
ATMS say Seta sh 101. 6 | 106. 2 | 101.7 105. 2 | 102. 8 | 106.8 | 102. 7 106. 0
OPaMenesnsea seh. 101.6 | 106. 0 | 101.8 105.0 | 102.6 106.7 102. 4 1u6. 2
CHORIN So nee 101, 4 | 106.0 | 101.3 105. 2 | 102.4 | 106. 6 | 102.4 | 105.7
PA Sap 0 ene ees sera 101.4 106. 2 | 101.0 106. 4 102. 0 | 106. 0 | 102. 0 105.5
Shp amale ease ee 101.2 105. 2 | 101.0 105.3 102.0 106.1 | 101.6 | 105. 6
Cig Seopa ase 100. 8 105. 2 | 101.0 104.8 | 101.6, 106.2 | 101.6 | 105.8
HOMO = ee ese oe 100.6 104. 6 | 100.5 105. 2 | 101.6 105.8 101. 4 105. 6
DSS te me cenit 101.0 104.2 | 101.0 104.5 | 101.3 105.8 | 101.6 | 106. 2
12 midnight........ Inj. tuberculin K. | Inj. tuberculin K. | Inj.tuberculin S. Inj. tuberculin S.

68

Temperature as taken before and after the injection of tuberculin—Continued.

349

Hour, Apr aa) Apres.
Before | After
aeons |anjeetien:
|
Raia th sn are ape eats see ened 104.8
Sai mpeeCteweer ee | 101.3 104. 5
Oasis le hose mn 101.8 106. 0
Wasinesn esse | 101.4 106.7 |
Tia ae hee 101.8 106.5
IPmoon: =f Pei Webi Be 106.0
EDS agate n a's ~otet efe = 101.6 | 106. 2
AF Se rise oO 101. 7 106. 2
TPUioanaece tase 102. 2 | 105. 6
Asp; Milnes sae eee 102. 6 105. 8
Dp ylib pead-ebe: S5- 102. 2 106. 0
GMa ve votes 102.2 | 106. 2
Uf re eR eee 162. 0 105. 8
Spe ese 4 101.8 105.0 |
Op alee ria er eee 101.8 | 104, 2 |
10 Pmt e eetaeee 101. 6 103.8
DAO aNd eyo eee 101.6 | 103..5 |
2 midnight....-..- Be tuberculin S.
303
Hour. | Ape. 1. | eaecat L Ho
Before After
snjecten: injection.
UE Capp acaesed le oka eeSe 102, 2
Biase sos ie 101.4 102. 2
Oram <-2 or ese | 102. 2 101.8
Oi soS eee 102. 0 101.8
Ulam ss. aan } 102.0 102. 6
[2 MOOD ese a 101.8 103. 6
fl pee ne a ay 101.6 | 103. 4
PAU UNE 55 aeons 101.2 102. 6
Sepa ot vere eee 101.6 | 103. 0
ANDI seem ae 102. 6 103. 4
oe Gad ever stor ere 102. 2 103.8 |
Gio tiles ote ote 102.5 103. 4
[g) (ait Mee ae onsite } 102. 2 103. 4
Sipse ss- e cese ee | 102. 0 102. 4
Oiphmerse as ee eeoe 102. 0 102. 4
LOM psa a ters petatoerers 101.8 102. 2
SUI Oe tele Se se Sos ote | 101.8 102. 0
2 midnight........ Inj. tuberculin S.
357 Ke
Hour May 1. | May 2.
Before After
nee tion. injection.
FT RCSA a, ery cep ceata eter iene | 102. 4
S30 BRL ieee kos Ono eas. Soci 102. 2
DaAM soles eeens | 101.8 102. 4
UE ai eeesoneaaaoe | 101.5 | 102.6
UNS 0 see ae ono 101.7 | 102.8
D2moonc2 ese. 2 > 2 es, 102.9
pa ee 101.4 | 102.8
PANU OL anes An 4s See 101.8 | 103.0 |
Spam she saeet et 101.8 102.8
ASD sdUlsrermer es sierra a)=1= 102. 2 102.6 |
BAUR OS ee Re SiG ' 102.6 103.0
Gpimseetes Seaeee ls MOD Butoh
(MIRAE Sea sacue 101. 4 102. 2 |
Sip AM ayaa oe oe 101.6 | 102.0
pa hee 101.6 5 101.2 |
10m sm... hae eee ee 10024) oes 4
Ailspemiz sane =e 101. 4 | 101.5 |
12 midnight-.....-.-. | Inj. tuberculin S.

350 351 352
|
bie 12. [ Apr. 13. | Apr.12. | Apr.13. | Apr. 12. Apr. 13.

| Before Atter | Before | After | Before After

pacer injec tion. ee meee ‘injection. a ai

BS oie ) KO) fe! tee Bes Sat LOSS U2 eet 103.0
100.5 | 101.0 100. 0 104. 3 | 102.3 103.0

100. 6 103. 4 101. 2 105. 4 | 102.6 104.9

| 100, 4 106. 0 101.6 106. 6 | 101.8 106. 2

| 100. 6 | 105. 4 101.6 106. 4 101.4 106. 2
100. 2 | 105. 0 101. 6 106. + 101. 4 105, 2
100. 6 105. 0 101. 2 106.2 | 101.6 105. 2
101.2 104. 0 101. 4 105. 8 | 101.7 104. 2
101. 6 104.8 101. 0 105. 8 102.4 | 104.4
101.5 105. 6 101.4 106. 1 102. 6 105, 2
101.6 105. 6 102. 6 106. 4 102. 8 » 105.3
101.5 105. 6 102. 4 106. 2 103.0 | 105. 0
101, 2 105.0. 102. 2 106. 7 102. 8 104.5
100. 8 105. 2 | 101.8 105. 8 102. 8 104. 2
100, 8 105. 4 101.7 105. 8 | 102. 2 104, 2
100.8 . 105. 4 101.6 105. 8 102. 2 104.1
101.0 , 105. 2 101.6 105. 5 102. 2 104.4

Inj. tuberculin S. Inj. tuberculin S. | Inj. tubereulin §.

304
May 1. | May 2
Betore After

injection. injection.

Lisset eel 102. 8
eto Soa 103, 4
101. 8 | 103. 2
102.2 | 104, 2
101.8 | 105. 4
£ Stet hees 106. 0
101.5 | 105. 6
101.8 105.4
101.8 104.8
102. 6 104.4
103.4 104.8
LOSS Ale ae ee sae
102. 6 106. 0
102. 2 105. 6
102. 4 105. 0
102. 0 104.5
101.8 104. 2

Inj. tuberculin 8.

395

May 1. May 2.
3efore After
injection. injection.
Se eS ee 101.6
BF Sees Pent 101.6

101.4 101.2
101,24} 101, 2
101. 2 101.6
pnp cee es 102. 4
101.3 102.8
101.6 103. 8
101. 2 108.6 |
101.8 | 104. 6
| 102. 0 105. 0 |
| LOZNOnte ss seeeees
| 101. 2 | 105. 6 |
| 100.8 105. 4
100. 8 | 104.6
100.8 | 104.0 |
100. 6 © 103. 8

Inj. tuberculin S$
|

355

May 1. | May 2.
Before | After
a hase injection.

eters 2 101.8

Sie aeblice 8 101.6
100.5 101.8
100.8, 102.0
101.0} 103.2

Tie a 103. 9
101.6 104.8
101.6) 105.4
101. 2 104. 8
101.8 104. 2
102. 8 104.3
102.83) 722 Semen
102.0} 104.0
101. 6 103. 6
101.4] 1040
101.2 103. 2
101.4 103.0 |

Inj. tuberculin S.

356
ee. | May 2
, Before After
estan) injection.

SCONAOASCAMAN

epee he 101.

Metre so. 101.

| 100.4 101.
100.9 101,
100.8 | 102.

iy ee / 102.
100.8 102
101.4 | 103
101.8 103
102.0 103
102. 0 | 104

| 10029 eee
101.6 | 104. 0
101.2 | 103.7
101.2 | 103.5
101. 0 103. 2
100. 8 102.8

Inj. taberculin 5.

| 360

Inj. tuberculin S.

359
May 1 May 2 May 1. | May 2.
Betore After Before | After
injection. ieee injection. injection.
Prorat 104; 4) yo. 101.2
Soe ah stees 104.8 |. 222 ee 101.2
101.2 | 106.0 | 101.8 | 100.6
101.3 | 106. 8 | 101.5 | 100.7
101.5 | 106.9 | 101. 4 | 100. 6
Ste seen 10750) seme 100. 6
101.4 107. 2 | 101.4 101.0
101.3 107.3 | 101.9 | 101.3
102. 5 105.4 — 101.5 | 101.4
102.8 104.8 102.4 | 102. 2
102. 8 | 105. 2 102. 2 | 102. 4
LOB 2 eee eee | 102; A) creme
102. 6 106.2 | 101.6 | 102.8
102. 2 106. 0 101.5 102. 4
102. 4 | 104.7 101.2) 102. 2
102. 4 104.0 | 101. 2 | 102. 0
102. 2 103.6 | 101.0 101.8

_ Inj. tuberculin S.-

69

Temperature as taken before and after the injection of tuberculin—Continued.

|

301

361 rel 362 3 Ge
oth pated sa er Poel UP Ns aoe a RAE
Hour. | May 1. | May? | Mav 1 May 2 | May 1. | May 2. | Mar. 21 | Mar. 22.
|, Before | After | Before After | Betore After | Before After
injection. |injection. injection, paection: eo injection. jinjection. injection.
A ESE ; SE ice ae aoa aes | AO a AR Yes
| |
Hance serine ral icra BE NE | 101.6 |...--..-.- LOZE GUE eee ee LO Qe Ol Serene Sreavee 104. 2
SS): ie TMA sy Si Pe Lace le HOU) jcccassesec MQ Baa cia emta) ya 102.4 100. 4 104. 8
OVA SIMescoe. eae | 101.6 102.4 | 101.2 | 104.0 | 101.9 | 101.4 | 100. 5 | 105.7
NOMA IMS pS SSS ise) 101.3 103. 6 | 101.4 104.4 | 101.2 | 102.4 | 99.8 | 104.6
Tis ne as elena eee 101.6 104.4 | 101.2 | 104.8 101.3 | 103.8 99. 6 104.9
12 OOS See eR Ses aaa lesemes ee | 105} 2 lesasescees IO 2 ecosotasse i 104. 4 100. 8 105.8
I) Wess Seb aeecaae 101. 2 105. 0 | 101.2 104.0 | 101.3 | 105.4 101.4 105. 6
Y90)s Seance ees 101.2 | 105. 0 | 102.0. 108.6 | 101.6 | 106. 0 101. 2 | 105. 6
3 0b Wis acoseoueosoe 101.8 | 104.8 | 101.8 | 103.0 | 101.5 | 105. 0 102.0 | 105. 6
ab TO. iis Bese sieososas 102. 4 | 104. 2 | 102. 2 1038. 4 | 102.4 | 105. 0 | 102.7 106.5
DEDMIMGa ice cies sor 102. 6 | 105.2 | 102.8 | 103.4 102. 8 | TM ee eee se 105. 2
Gp pees teria e | HOR @ jse-ceseee: bo NOES Bete acid oc NOSE 2m Rearertacs elODeria 104. 8
TOs a Geesoseoseealh 101. 6 105.8 | 101.2 103.8 101.8 | 105. 2 102. 0 105. 0
Sh Wo cles soeeuecee 101.7 | 105. 5 | 101.2 103.6 | 101. 6 | 104.0 101.8 | 104.5
OWT a tee Cres 101.6 | 104.5 | 101.5 | 102.4 101.6 | 103.4 101.9 103.8
HOSTS MM yep) =. 101.4 | 103.7 101.4 | 103. 0 101. 6 | 103. 2 101.8 103. 6
DAG Rees eee 101.4 | 103.2. 101.2 | 102. 6 | 107.8 | 103.0 NOES Cees
12 midnight ......., Inj. tuberculin S. | Inj. tuberculin 5. | Inj. tuberculin =. | Inj. tuberculin K.
! | |
302 305 307 308
Hom | Mar. 21. | Mar. 22. Man. o1, | Mar. 2 Mar. 21. | Mar. 22. Wis a1. | Mar. 22.
| Before | After | Before | MO: Before | After | Before | After
\injection. injection. injection. injection.| injection. injection. injection. | injection.
1 DST SoeleeSieo HOES peers ae ees OA Mare sted emis NDZ ste) Woe sogoseae GB ise boseoeor 102.7
(3 Poll csegeBorememel 99. 8 105. 2 | 99.6 102.4 102.0. 103.8 101. 0 102. 8
Chis ly Soap oon eaee 100. 0 105. 8 99. 4 | 102.0 | 102.0 104.2 | 101. 0 103.0
ill ey, Woven eseeesooodes 100.5 | 105.2 | 100. 2 | 101. 2 101.8 | 103. 6 | 100. 6 | 102.8
AGI Ze Ae S5odos sb 100. 2 | 105.8 | 100. 2 101.0 102. 0 104.2 | 101.0 | 102.7
AZ MNOOMGs sees ie es = 100.6 | 106.8 | 100.4 | 101.0 | 101.6 | 105.4 | 101.0 | 102.8
Peco ee sete 101.0 | 106. 5 101. 0 103.3 101.7 105. 8 | 101.4 | 102.4
SPT. ees So Sei sacsy et 101.0 | 106. 2 | 100.8 | 101.2 102.0 | 106.3 | 101.2 | 102. 6
Dope relteistaie 2s 101.6 106. 0 | 101.2 | 102. 0 102. 0 | 106. 0 | 102. 0. | 102.8
AND MAN ee eye ee. eee 102. 0 106.5 | 101.7 103 0 | 103. 0 106.2 | 102. 0 | 102.8
SUNRDEPIUMY serene oral asin kievalevofans NOCH OMe see Nala yore LODO sees 102.5
Gipenase seers ese 102. 2 | 105.4 | 102.0 102.5 | 102: 2 | 104.0 | 102.0 | 102. 2
TOs) gaan eee ae aes 101.8 | 105. 4 | 101.8 101. 8 | 102.5 | 103.8 | 102. 2 | 102. 0
SPIN cbeensosseace 101.7 105. 0 101.5 101.8 | 102.6 103.8 | 101.8 101.5
eam oR 101.3 | 104.2 | 101. 4 101.4 | 102.4 103.0 101.7 | 101.0
ORs Ss) 101.6 | 104.2 | 101. 4 101:8 102. 2 | 103.0 | 101.8 | 101.3
IU opi Cee ae ard HONSO een nesace | ACO AO) en age a | OD HOP eat Sey TOM): Honea eseees o
12 midnight........ Inj. tuberculin K. | Inj. tuberculin K. | i path tuberculin K. , Inj. tuberculin K.
|
309 | 310 312 313
| j crit)
Hour. | Mar. 21. | Mar. 22. Mar. 21. | Mar. 22. | Mar.27. | Mar.28. Mar. 27. | Mar. 28
| Before | After | Before | After | Before A fter Before After
injection. |injection. | alee tion. injection. imection: ijeeron. spiceu gn PAGO
UNE BO NS | is E oe | eis bees Nay et ko
Nal es et eae Ae NE ee LOB RT| ete ee Gee TOMS Re rseyaese ees 102.5
Sueded yeaye Speyavepeyer sicher | 101.5 | 102. 4 | L022 | 103.8 100.8 | 102.8 100. 6 102. 4
OAS Skee ooeeae 100. 8 | 102.3 | 101.8 104.0 | 100.9 | 103. 0 101.5 | 102.4
MU) Reames eek er ee 101. 0 | 100. 6 | 101.4 | 102.0 | 100.9 | 104. 4 | 101.5 | 103. 2
Ten eReesare ease sere 100.8 100. 7 | 101. 2 102. 2 NOT 104.8 | 101.8 | 103.8
IE} TYO ieee oeeeae 101. 2 | 101.4 | 101.2 102.8 | 100.8 104.7 101.8 | 104.0
IM Cys So eee eae 101.2 | 101.6 |! 101.6 102.8 | 101.0 } 104.2 | 102.0 | 104.4
POTTING Cape ceases eran 101. 4 102.0. 101.8 103.5 | 101.2 104.0 | 102. 2 104.0
[OSMIUM sparse ys cus Se = 102. 0 | 102.4 | 102. 2 104. 0 | 101.7 | 103.4 | 102. 0 103.5
JOT OSA ease eee 102. 4 | 104.0 102. 6 106.0 | 102.0 104.0 | 102. 4 103. 4
Dhl seodedaoanesm hes ea sacl OBR OME fares ee ee 104.4 | 102.0 | 103.8 | 102. 2 103. 0
Gupsamlee see se soe 102.0 | 102.5 | 102. 2 103.5 | 101. 6 | 108. 5 | 102. 2 103. 0
Hie PUD ctclarss satya 102.0 102.1 | 101.8 103.0 | 101.2 | 104.0 | 102. 6 | 1038. 2
S710) Wl Godonese soe s 101.6 | 101. 6 | 101.8 102.4 | 101.5 | 104.0 | 12.2 | 102. 4
Us Wo estes deste 101.4 101.5 | 101.8 102. 2 101. 0 | 104. 2 101.7 } 102.5
10 es BER BONE 101.8 101.2 | 101.8 | Ee 101. 2) | 103.8 | 102. 0 | 102.5
Ds ile kee dsascacs | OTE G learns stayeicte eve | MLO Oi lietevemters eto 101.0 103. 2 102. 2 102.2
12 SAE aeieee eta Tj. tuberculin K
|

| Inj. tuberculin K. | Inj. maercuii K.

| Inj. tuberculin K.
|

70

Temperature as taken before and after the injection of tuberculin—Continued.

315 316 317 | one
How Mar. 27. | Mar. 28. | Mar. 27. | Mar. 28. | Mar. 27. Mar. 28. | Apr.12. | Apr. 1B.
Before After Betore After Before After Before After
injec tion. injee tion. injection.| injection. injection. Alogi: hisses = Renae
WiaeIns ce eee | eee | 1028s lteter ase aee TURE Se ie eae 102. 6 L2pereee 104: 4
Saat ws aceecase 100.0 | 102.8 102.0 103. 0 101. 6 | 102. 0 | 100.6, 103. 0
Dagan see 100.0 | 103.4 102. 1 103. 0 101.5; 102.11! 99.8 103, 2
LO avn Se ae eee 100.5 | 103. 6 102. 8 | 103. 9 101.4 | 102.4 100. 0 104.6
Na Pe sees ane 100.5 104. 6 102.8 | 104.5 | 101.4 | 102. 4 100. 3 105. 3
12 noOni==- = 2- see 100.8 105. 0 102.4 106. 0 © 101.0 | 102.5 100.5 106. 0
passa eee eee 100.8 105, 2 102. 6 106. 0 101.2 | 102.7 101. 6 106. 0
PAU Oa ae Sie oe 101.0 104. 6 102. 6 105.4 101.3 101.8 101.6 105. 6
3H Ne leeds 101.6, 103. 2 102. 4 104.8 102.0 101. 2 102.2 106. 2
AED eter ee re 102. 2 | 103. 4 103. 1 105. 4 102.2 102. 4 103. 2 106.8
A Ou oPyae ae saor 101.8 103.2 102.5 105. 4 102.8 | 102, 5 108. 4 107.2
Cipla se neem 102.2 103. 0 101.4 105. 0 102. 4 | 102 2 102.8 106.5
Theol anereoee ss 5 101.6 103. 0 101.5 105, 2 101.8 102.1 103. 0 | 106.4
B pee. canoer = 101.8 102. 0 101.6, 104. 6 102. 0 102. 2 102.8 | 106. 0
OiPFMseees ess 101.6 | 102. 0 101.8 104.5 102.5 101.8 102. 5 ; 105. 6
LOsp eset aaa 101.5 | 101.8 101.6 | 104.5 | 101.8 102.0 102.5 105.8
Lp eee sree 101.6 | 101.5 101.6 | 104.0 | 101.8 | 101.8 101.8 105. 6
12 midnight--.----- Inj. tubereulin K. Inj. tuberculin K. Inj. tuberculin K. le Inj. tuberculin Ss.
319 320 321 $22
Hour. Mar. 27. | Mar. 28. | Mar. 27. | Mar. 28. | Mar.27. Mar. 28. | Mar. 27. | Mar. 28.
| Before After Before After Before After __ Before After
injection.) injection. injection.| sage emeeaean injection.| injection. fees
(Pee eases eet pes bare OA RSs 103} 0" | P22 ees | 122) aoe seen 101.8 | iseteneeas 102.0
S'ae Ms eee eee 101.9 102. 0 101.9 101.0 101.4 101.2 | 100.8 | 100.8
aim. >..- seve 101.8 102. 0 101.6 101.4 101.6 101.2 101.4 100.8
AO NA see 101.5 101.8 101.3 101.9 101.4 101.4 | 101.0 | 101.4
10 UP er co eer at 101. 4 101.8 101.4 102.2 | 101.3 101.4 | 100.9 102.4
19 neon 2-2, ccber 101.4 101. 6 101.2 102. 2 101.4 101.4| . 100.8 103. 8
YS UM ee anata eeuat 101.4 101.8 101.0 102.6 101. 2 | 101.4 | 101. 2 104. 2
2PM sa a-eeteee LOT 101. 2 101, 2 | 101.4 101. 2 101.2 | 101.6 103. 0
Spal Rear aes 101.9 100.8 102. 4 | 101.0 101.8 100.4 | 101.8 101.0
oat Ro aase aoe aoe 102.6 101.6 102.8 | 101.6 102. 2 101. 2 | 102.2 101.4
SO Ne ee eee 102.8 102.8 102.8 | 102. 0 102.0 102.0 | 102.8 102. 8
Lp] eh Te Sree 108. 0 101, 2 102. 0 | 101.8 102.5 101.6) 102.6 102.0
Yai TS AAS pa eA 102.6 102. 2 102: 2 | 101.8 102. 4 | 10158); 102. 6 102. 2
SPAM aoa eee onl 102.5 101.5 101.4 101. 2 101.8 101.2 | 102.0 102.0
Olp aaa eee 101. 4 101.6 102. 2 | 101.4 102.0 | 101, 2 | 102. 0 101.2
10 pamien Ao 5S 102.0 101.5 102.0 | 101.2 102.0 | 101.5 102.5 102. 0
LA peta stn oe 102.0 101.3 101.6 101.0 101.5 | 101. 2 102.0 101.5
12 midnight-.-..... Inj. tuberculin K. | Inj, ee reulin K. Inj. tube sreulin Kk. Inj. tuberculin K.
|
323 | 324 325 326
Hour. Mar. 27. | Mar. 28. | Mar. 27.| Mar.28. May 25. | May 26. May 25. | May 26
Before After | Before | After Before After Before After
injection. injection. injection. /injection. injection. peg injection. jinjection.
| |
| |
Taos oer woo eles ee ee 103216) 's22- ce see | 10D. Quer 101-8) 1. aetna 101.8
Side Ms tees ie seas. 101.0 102.8 | 100.9 | 105.9 | 101.2 101.8 102.0 102. 0
Ch 15 1 eee ee ay 101.4 103.2 | 101.2 | LOG Die ears ole 101.2 ie sees 101.3
LO aM ic eee hehe. 101.4 103.8 101.0 107. 0 101.4 101.1 | 101.9 101.5
Lsacm oes eee 101.4 105. 0 101.2 LOG26 42 22 Ae 101.2) {2 eee AO. 7
LZ MOOD)- a eros ee 101. 4 | 105. 0 102.0 106. 2 101.2 101.3 | 101.6 101.8
apn eee = ae 101. 2 | 105. 2 101.8 LOG! 23) 5. eee 1O1K6 eee 101.8
2M keener =i 101. 6 103. 6 101.9 106. 0 101.1 101.4 | 101.7 102. 4
Dipedieten ee acne 102. 2 | 102.8 102.5 106 7s lick seer nKt) Oe Goer Si 103.4
ADIN Ge ore ap meee 102. 6 | 102.5 | 102. 4 106.0 | aD) 7 a BR yan T01..8:)\.o-- eae
DID NEA se eer eae 103.4 | 102.8 102.8 106. 0 | déeladeeoes LOS20 "See esse ee | 103. 0
(iy oe AEBS ee obemnr 102.6 102. 2 102.6 106. 0 102.8 103.0 | 102. 6 103. 0
(hope eames eae be 102.2 | 102. 6 102. 2 LOGH els ae Re ome 102:'6 (ae | 102.5
Spe 2 sos ee ee as 102. 2 | 102. 4 102.1 106. 2 102.6 102.6 | 103.0 102.3
OPE 42 saeieweeee 102. 5 | 102. 0 102.6 POG HG, Sec oc 102.'2)-2 5 Sota 102.0
LO planesesa-ot ee as 102. 2 101.8 | 102.0 105. 2 | 10235) | s4 eee 102.4 |\..062e ee
Livi simie scree ae 102.0 101.6 102.3 105. 0 | wis Spe ewes ome ome Sal ee ee
12 midnight. -..-.--- | Inj. tuberculin K. | Inj. tuberculin K, | Inj. jaberoalaa S. | Inj. tuberculin S.

|

71

+

Temperature as taken before and after the injection of tuberculin—C ontinned.

27

3

328

329

“Ame. 12.
Before |

| Apr. 13.
After

|

Riis 103.0
| 10201 - 102.6
| 101.4) 103.9
101. 2 | 104.6
101.0 105.2
161.0 104.8

| 401.2 104.0
| 100.8; 103.6
| 100.7} 103.2
101.0 103.2
101.5 103.5
101.4 104.2
Hoi dose

| 101.0 103.6
101.0} 103.4
401801). 110315
0) 2

101. 103.

Honr. ven 25. | May 26. | Apr.12. | Apr.13. | Apr. 12. | Aone.
Before After Before After Betore After
‘injection.| injection. paiection- injection: ipections [injection. -| injection. apie CnONs
Z eat a | as
T CLE eee ne Rees nee oe loyal ODES es aise: UO eve renee 104.0
Or eVesM eye es cs peinel= 101.6 102.4 101.7 101.8 102.3 104.2 |
Osetra a eens aiel| a eiscl= sare = 102. 2 | 101.5 | 102. 8 | 102.3 104. 9
MO FARSIME eats ese = lar 101.6 | 102. 6 | 101. 4 104.0 | 102.0 | 105. 8 |
il Msi See seeunoa laseosesees 102.9 | 101. 4 104. 0 102. 2 | 105. 6
1znoon.-.--.--.---- 101.3 103. 2 101.0 104. 6 101.8 | 105. 6
iT Tie Sees ae eae 103.0; 100.8| 104.6 101.6 | 105.4
VAs ssa e so Rea eae 101.6 103. 6 | 101. 4 104. 0 | 101.8 | 104. 8 |
Pio. WN sossebossonselposesusoce 103.0 | 101. 4 108. 4 | 102.8 105. 2 |
Abyss ae alas = 5 | 1025 O Necenssenas 102. 7 | 105. 4 103. 4 105. 6
HP. WN sscaseseeeasoleocesosss | 103.2 | 102. 0 105. 4 103. 2 | 105.2 |
OipPSMere teens 102. 0 102.8 | 101.8 104.5 | 103. 0 | 105.2)
(10, NSS socmearaees (cete seibye ie 102. 5 | 101.5 | 104, 2 | 102.7 | 105. 0
GMS pe eas ene | 101. 6 | 103. 0 10i. 4 | 103.8 102.6 104. 6 |
GW. WNS- sososueemes lee. Gore | 102.6 101.2 103.0 | 102.7 | 104. 2 |
Ojos Mescassaseoees HOW Si eee aac 101.2 | 102.8 | 102.6 | 104, 2
Ds Re see Serer cya len hes gst Pe 100) el 5 102.2! 104.0

|

Inj. tuberculin 8S.

| Inj.tubereulin S. |

35L

Inj. tuberculin )

Inj. tuberenlin S.

| 334

332 388
| |
Hour | Apr.12, | Apmis. | Ape 12: | Apr i3.| Apr.12. | Apr. 13. | Apr. 12. | Apr. 13.
Before | After Betore | After | Before After Before After
| imection:, paBecuion: Eauection. Becton: [ever | Injection. | injection.| injection.
| | Me !
Fst eee Peer te Gee ee eee | 104. 4 | i Garett: he Spe a ae ee ho Le
(3 lg W= ss se50e0dc0ee | 101. 8 | 103. 2 101.2 | 104. 2 | 102. 4 | 102. 0 101.4 101.6
Ole TWisvsece ace son | 101.8 | 104. 4 | 102. 0 | 104. 6 | 101.9 | 102.8 101.8 | 101.0
NOkaesmisssesae since - 101.4 105. 2 101.8 | 105. 8 | 101. 0 | 108.5 100. 4 101.0
hve se eco 101. 2 | 105.4 | 101. 6 | 105.4 | 101.4 | 104.7 100.2 101.0
AD NOOM 22. 22222. 101. 0 | 104.8 | 101.4 | 105. 4 | 101.5 105. 4 101.2 101.0
AGM ys sis - A) = = 100.8 103.8 | 101.6 104. 8 101.4 | 105. 6 100. 8 101.0
Ooms 5 sh eae 101.2 103. 2 101. 6 104. 2 | 101.0 | 103.9 | 100.6 101.2
Bait ass See oe ee 101.4 104. 2 | 101.2 103. 5 100.5 | 103. 2 | 100.7 101.8
AT Te seoasnense ee 101.8 105. 2 | 102. 8 104. 9 101.8 | 103. 5 | 101.8 | 102. 2
Bits Nseocseasoaees 101.4 | 105. 6 | 102.7 105.8 101. 6 | 103. 0 101.5 |. 102.5
Gipamieee se 101.6) 105.8) 102.4 106.2 101.6 102.2} 101.6 | 102. 2
U0 ConeesSeaeee 101.7 | 105. 8 | 102.4 | 106. 0 | 101. 4 102. 0 | 101.6} - 102.0
Sipe ee ee eee = 101.6 | 105. 6 | 102. 2 105. 4 | 101.5 101.8 | 101. 4 | 102. 0
Opmmens se aes 2 101. 6 | 105.2 | 102. 0 | 105. 6 | 101.4 101.5 101.4 101.6
I) uASeSeeAsee bre 101.8 | 105. 2 | 102.0 | 105.,2 | 101.4 101.5 101.2 101.8
IU ite See e eee eee 101.6 104.9 | ae | 105.4 | 101.4 101.6 101.3 101.8
12 midnight. ....... Inj. tuberenlin 8. | In . tuberculin S. | Inj. tuberculin S. | Inj. tuberculin S.
| | |
; ;
330 | 336 337. a 339
Hour. Apr. 12.) pe. 13. | Lae 12. | Apr. 13. | Apr. 12. | Apr. 13. May 1. | May 2.
Before | After | Before | After | Before | After | Before | After
duecuon: same’ stion.| apecuion: an CuO n a) etn Roum apjes ‘tion. ‘injection.
} ! N 1
feaeaniaee ee i) sare ovsi2))osaa Salve, fs | MOQ 2S ee eee HORS OD lloesaesoeise UPS Tesedssgese 101.3
Glare css erases 101.8 — 102. 0 | 101.6 101.6 101.4 NOME alpseaceoaes 101.4
Ohamannayaccteeren. 2 cle oie 101. 6 102.6 | 102.0 | 101. 6 | 101. 4 102. 2 | 101.6 101. 2
OR AsSebeees paces 100.8 163.8 | 101.4 | 102.0 | 101. 4 | 102. 2 | 101.8 | 101.2
1) Bao See 100.9 104.8 101.2) 102.4 | 101. 2 108. 4 | 101.4 101.2
MO MOOM fee ace ce ae 100.9 105.2 | 101.2 | 103.8 | 101.2 OAR} eee ee 101.6
Hail, 6SeceebSaons 101.2 104. 2 101. 0 | 104. 4 | 101.2 104.8 | 101.1 | 101.4
Did: ise LeAnne eee HOU ae wlsnsy | et0n 8) 9 03%s) |) 008) | 10482) | 01. 4 102. 0
Sa ne Ga A 101.5}: 1028) 101.6) 103.5| 101.8! 104.4} 101.2 | 102.0
AN Tene reer rte Seay 102. 0 | 103. 0 102. 6 | 104. 4 101.6 104. 6 | 101.9 101.8
D ]OolMecossedsansss 101.8 | 102. 6 102.8 | 104.9 | 101. 6 104.8 103. 0 102.5
(Hj soesereeneee 101.5 | 102.2 | 102. 6 | 104.3 101.7 104.8 | IKPROW EES exh eae
Tape sats Ae oe ge 101.6 | 102.4 — 102. 2 | 104.6 101.5 105.0 101. 6 | 103.5
Sipmmeesersa mace 101.6 101.8 102. 0 | 103. 6 | 102. 0 104.6 | 101.6 103.0
OMe = eoegeaa a 101. 4 | 102. 2 102.2 | 103.8 | 101.8 104.5 101.4 102.8
(IO DSSS seer ecnas 101.4 101.8) 101.7 108. 4 | 101.8 104.5 101.0 102. 2
Me scree se ee 101. 4 | 101.8 161.4 | 103.5 101.8 | 104, 2 100.8 | 102.0
12 midnight...-..--. Inj. tuberculin S. | Inj. tuber culin S. | Inj. tuber eculin S Inj. tuberculin §
|

12

Temperature as taken before and after the injection of tuberculin—Continued.

340 341 . 343

342 |
Hour | May 1. | May2. | May in | May 2 2, |) May 1. ; May 2. | May 1 | May 2.
Betore After | Before After Betore After | Before After
heey injection. injection. ede injection. injection. injection.| injection.
TARA aoe eo eesee ee = 10156 | EP ate HOB OM isso ero aeee 101.8!) eee | 104.4
Sasso pone at ae see eae | 1027 04\o5 nee AOE O eres el 102,22 on eee . 105. 0
aah ss to ncees | 101.4 101.6) 101.0 | 104, 0 102. 6 | 102. 0 100.7 | 104.8
SG. Ws 38 Bases Seed 101.0 102. 2 100.8 | 104. 8 102. 2 101.6 101.0 | 105. 0
ab Bee spose rico | 100. 8 102. 2 101. 2 105.5 | 101.8 101. 6 101.0 105. 6
QTHOOM at esos Seale eee LOB20) nce scbecee MOGROS eroae ope OVA | Seas 106. 2
Apumi ee Se | 101.0 | 102. 0 101.0 105. 8 101.4 102.0 101.1 105. 6
Pag pat Weegee Eee Cee 101.2 102. 4 101.5 | 105. 6 | 101. 4 | 102. 4 101.0 105. 8
erp. tle, = sions eel 101.4 102. 6 101.5 | 105. 0 | 1()1. 4 102.4 101. 2 104.8
eh 1 ees See 102. 2 102.0 102.3 105.0 | 102. 8 | 101. 4 101.6 104.0
Renna so eee | 101.8} 102.4] 103.2 104.8} 103.4 102.3 102.4 104, 0
Gip WM = 2 is ose ae | LOTS Gaerne eee MORNE | J. 2 rete | POSS: ace ake ; 102,67) sepeaeee
Aina! oon see 101.0} 102.4 102. 2 106. 0 102. 0 104.2) 101.6 103.8
Sipe. sce a-ce eee 101.2 | 102. 2 102. 0 105. 8 | 102, 2 103.7 | 101.4 103. 2
OMS soa5e eles 100.8 | 101.8 101.7. 105.5 | 101.9 103.5 | 101.2 102.8
LOR wate ees 100.8 101.8 101.4 105. 0 101.8 | 103. 8 100. 8 102.4
CPUS SDM trate eee 100. 8 | 101.7 101.4 | 104. 8 101..8 103. 4 100.8 | 102. 2
12 midnight........ Inj. tubercalin S. | Inj. tubere ulin S Inj. tuberculin $s, Inj. tubereulin S.
B44 345 346 347
How May oh May 2. | May 1. | May 2. | eae i. fee 2, | May a Re May 2.
| Before |. After Before After | Before After | Before | After.
Linjection. injection. injection.) injection. injection. injection. injection. injection.
|
MMVI ee eee ns oe) Se ceeerer TCG Re We as LOS LB Sees 1014 |e Sees 102.0
SMM soe. se net ee ela een eee OU AN oe Homa UE BOE mae oe ee L012) 2 es ae | 101.8
9iasmM'S-o ..- Sete s 101.0 100. 4 100.8 103.8 | 101.4 101, 2 101.8 100.6
MOMS oo teeta 100.8 100. 4 101.2 103.8 100. 2 101.8 101.4 100.8
kay Ms ce at oe eee 100. 6 101.2 | 101. 2 103.8 100. 8 101.8 101.6 101.2
AZNDON ae = oot ere ts ie reais LOO Pale seco LOSS Ae aoe ta ela | 102./8)-2. .oeeees | 102
1 eg ae icietee see 100.8 100.4 101. 2 | 105. 6 100.8 | 103. 0 101.0 101.4
Qpsmeeaetebnees se | 101.3 101. 2 101. 2 | 106. 0 101.0) 103. 2 101. 6 101.6
Bhi US Ariae eas une 101. 2 100.8 LOS.) 105. 4 101.0 103.0 | 101.8 102.0
QspiyMixa.c ae shee | 102.1 101.6 101.4 104.8 101.8 103. 2 102.4 | 103.0
Spams et ses 102.0 102.0 | 102, 2 105. 2 102.4 103.4 — 103.6 | 103.5
Gps .222 55 S83 102.42 | tee | RODS A. taeiiaete LOZ GOS eres | 102,:8'| 2. 22,25
(is eee eee 101. 2 102.0 101.2 | 106. 4 101.5 103.5 | 103.0 | 104. 2
SIs ew opesise ses 101.2 102. 0 101.4 106. 2 101.6 103. 2 102.8 104.2
OBPwMe ss. este 101. 2 101.5 101.2 105.8 101.4 102.8 102.8 103. 4
Do Ne ogee 100. 8 102.0 101.0 105. 4 101.4 102.5 102. 8 | 103.5
psec aes eee 100.8 101.8 100.8 | 105. 0 101.0 102.2 | 102.8 | 103.2
12 midnight......-. Inj. tuberculin S. | Inj. tuberculin S. Inj. tubere ulin 8. Inj. tubereulin $.
|
348 | 349 350 | 351
Hour. ‘May L May 2, ahi May 1 May 2. | May 1. May 2 2. | May 1. | May 2.
Before After Before After Before | After | Before | After
‘injection. injection. | pie ree es injection. injernon |injection. + eres
| |
Fie, Os ONE hae: ere TTT ih One 108: 6)| eteps e 101: 2, aa | 108.8
Sh RR UBER RCE OSE CO CUGSIE BE Sean OMG leer eterna WO BS 2 ceierapee ees 101. 8). 62s 103.8
te ey Fea Ne een B-peeh 101.6 100. 8 101.5 102.5 99.2 | 102, 2 | 99.3 104.0
LO ANIME. Sy ees 101.2 | 101.4 101.6 102.8 99.1 | 102.1 100. 0 103.6
A LC 06 ere aaa ie 100.8 | 101.8 101.5 103. 0 99.5 102. 2 100.0 103. 8
AMGON Ks Jos. Seles |nems seine | OD Ae. See { LOBY4 || cos aceee 103.05). pace ee 104.8
I p.m--..2..-.-.-. 101.0 102.4] 101.5] 103.4 100.6) 102.8 101.0. 104.8
ADM HM: 2b sass. 101.4 102.6 | 101.6 103. 3 | 100. 8 103.4 | 101. 2 | 105.0
35D aM eee a ae ele | 101. 2 102. 2 | 101.6 103.0 101. 3' | 103. 5 | 101.6 104.6
AN soe ets | 101.8 102.8 | 102.0 102.8 101.8 | 104, 2 | 102. 2 104.6
DPM ea Fon Be sere | 102.0 103. 2 102. 0 103, 2 102. 2 105. 0 / 102. 2 104.7
GPM perce Sass | LOW AG: || eee LOW Sc ee. eet LOU: GN. ates ~ 102.4).|°53 = ee
Wee Wine ta Eee sieve 102.0 103. 2 101.6 103.8 | 101.6 104.8 102. 2 105. 6
Sips me. Sse sade: 102. 2 102.8 101.6 103.2 | 101.2 104.6 102.2 105, 2
insane. een 102. 2 102.6 101. 4 102.7 | 100.8 104. 4 102.0 104.5
LOM oils ae eS 102. 2 102. 4 101. 4 102. 2 | 100. $ | 103.8 101.8 104.3
WAT Leni pete oe 102. 2 | 102. 2 102.0 102.0 | 100.8 | 103.5 101. 2 104.0
12 midnight........ | Inj. tuberculin S. | Inj. tuberculin S$. | Inj. tuberculin 8. | Inj. tuberenlin S.
|

13

Temperature as taken before and «efter the injection of tuberculin—Continued.

352 | 303 | 304 | 355
iF ] | | | | |
Hour. | May i. | May 2. | May1. | May 2. | May 25. | May 26. May 25. | May 25.
| Before | After | Before After | Before After Betore After
| unjecnt injection.) injection.|injection. injection.| injection. injection. injection.
7 Co sae ee eae Ode [er es NOPE Re ewes IPPaprlQo 4a eeen oun 102.8
dei Saasoeuoseeer \oascosoeee Obi sea seceos 102.8 | 101.5 102. 5 | 101.8 102.6
W) Da WS Bae | 102.6 | 102. 2 101.7 NOS GO |oscasccoue HOP OSes oe oat 101.8
IUD ogseeaeses eee | 102. 0 102. 2 101.3 101.8 | 101.6 101.6 101.9 101.7
AMA yee esi cat 102. 0 | 102. 6 101.4 UPS Bal sacaooages LOD 4 ali Soe 101.8
12 mM00n =.= = =~. - = \esseesese- INP dl | eee oasose 108.0) 100.7 102.4 | 101.6 101.8
Ib; Osi Egon aeasOoS | 102. 2 103.0 | 101.0 | AAP Gin Reese eae ODS saeseces 101.9
Papen se isersen= = j 102. 6 103. 0 101.6 102.8 101.0 102.4 | 101.5 | 101.8
Sips sss | 102.4 102.6 | 101.4 10D SCs ees TOMS ees eas 101.8
4b osoncosbosaee 103.7 | 102. 6 102. 4 103. 2 | NOU OM eres MOU Wee ise sre See
Sis ecasoaseeuees 104. 0 104. 0 | 102. 6 | Wb} iy ESeseckoes OZR O Beeman 102. 6
Gipsms--2se 552-5. TOR lel ek ee IOUS Giesessoube. | 102. 6 103. 0 | 102.8 | 102.8
Haters sot eran ee OSHA ee ON 2 | OTE Ge 04 s3) ee WB Wsiscegeasus- | 102.6
ATs see SB Seeeeos 103.5 | 104.0 | 101.4 104.2 | 102. 6 102. 8 | 103. 2 | 102. 6
QjDs iN Sas oceecos ser 103. 0 103. 7 | 101.4 MOAR OR eae eee es 103. 0 | BSS Sue RaHS | 102.6
AOR hee Se ck: MOOS en Oda fee COLA 10346) 14 102K0) |b 2 | 102.5)...
iil Mi) Sas eA Se seeee 102.6 | 103. 2 | 101.4 NOS R2E |e eee es eeetear ea | eeeaettaeceae ones cement pers
12 midnight..-.--.-. Inj. tuberculin S. | Inj. tuberculin 8. | Inj. tuberculin S Inj. tuberculin S.
356 357 358 | 359
Hour. May 25. | May 26. May 25. | May 26. | May 25. | May 26. | May 25. | May 26.
Betore an iter | Before | After Before | Atter Before After
jeaiseom injection. injection. | injection.|injection.| injection. | injection.| injection.
Rete erote es oa-|S 2 02 Sea basoplOLD ia sal OPS Will seeeaees O26 2 hoe ee 101.4
(3 Gia eae sy eRcOne ee | 101.6 101.4 101.4 | 102. 2 | 101.2 102. 0 | 102.0 | 101.4
OM, WSs Seb boas sepals ecsseae | WUE ee caeseess TOMO lssecosous VPS) ons eesowe 101.2
DAG ni Seseaseueosee 101.1 | 101.2 101.5 | 101.7 | 100. 6 101.8 | 102. 0 | 100.8
iil Me it) eee AS 5 easel beasoeees LONER ete NOB Oi |esessacuad NDNGES iseeesoseds 100. 6
PRN OOMPe rick 2 =- 2 101.1 | 101.4 | 101.2 101.5 101.1 101.8 | 102.1 | 100.8
finite see oo shee axe pee IONS 2b Gace sean emia O13) eee ees TOTS ee eeu 101.2
Us sospee soos ee 101.3 101.7 | 101.4 101. 4 101.4 102.0 | 102.8 | 101.5
3). Wi oneaodencesds| sansa aes | IEDM ea ssenen es OMA ese sere sec] NOS Os eiessoceus 101.2
Maen ees ca AGILE) | eee Pea osGn oe area, THOU es ae eae ciel OSG Masel
Dfds WN ya sdacecosnesllaoopoeeose WPS OO ebaee scone NOE Oeseseseecs Oe Oe sapere 102. 2
Glos iN padocccasease 102. 0 102.8 103. 0 102. 9) | 101.8 102. 6 | 103. 4 103. 0
TOs WSs ssedsdosdnclocosecagee | OPN Be Sete daes NU On tesusseceal TO 2M OMe ee 102.8
Sipemige ss s-as- 2: | 102. 0 | 102. 4 103.1 101.8 | 101.6 102.1 | 103.2 | Calved.
Gipstotee eins) =\- = loceoecesse | M2, 2 \oeseeeacas | 1p 8) |sassssccos NOD Qe jeeceeaas [Sreseerars a
IOs Sesne scene 101.7 seabceneas] ODOR Saree NOUS in skeogsss< HUBS O Issasocasac
ill js tlie seegasseabe SERDAR SS AGI Reegecre ecaelal eee eee seevete [mete eres esis oa ONe SAPS se ese eae [ee tomeNs
12 midnight .-.-..-.. | Inj. tuber eulin S. | Inj.tuberculin $. | Inj. tuberculin 8S. | Inj. tuberculin S$.
| | | |
| 360 361 362 363
Hour. May 25. | May 26. | May 25. | May 26. | May 25. | May 26. May 25. | May 26.
Before | Atter | Before | After Betore After Before Atter
| injection. injection. injection. |injection. polecuon: imjeetion. injection. injection.
| | IP “is
(ia, ie eae ee heen ees MOMS ee ree Pam OQue ecm SEE TGQ 2b aes ome | 101.8
Ee MesssoHapesoee | 102. 2 101.8 102.2 | 102. 4 | 101. 0 | 102.4 | 100. 9 102. 0
eis eases sSe poe HONS Wee eeaecage NOM Woasagsaneee M022) eae se 101.6
Lats APS SAS As ase 100. 8 101.4 102.0 | 101.7 | 100.8 | 102. 0 | 100. 8 101.6
TIL Be Tas eae ee eat rae Ve a OMA nee ioneueel O15 eeu eis {ee sh 7in eee eel 101.6
2 MOOMB=siatse) 1-7 =< 101.0 101.6 | 100. 9 | 101.6 | 100. 7 | 102. 0 100. 7 101.5
i) Date sess ssenaces| Meeaae sae UGS) ES Sescsoc] | NOMERY | Seaseseuae | NOS eyed eaenass 101.6
ePe We wa wse a 101.5 101.8 «101. 4 101.8 100.9 | 102. 2 101.0 102.0
SVs lls esascesssaen aS eens OTC eecene os. LON 3 |eacasacdss NUP Ss AES Scoces 102. 2
Aipesmas eee occ [potest OU) snares 5. TVISG enone gece |euel Ole Gylpasaeone TOUS |S see Raee
BypNIs sa seoaes ise [eres Seer ale TODO see. [peer OOS OR remap: eae UPR ease eats oD 102.7
OD Wlscassacosaees 102. 2 102. 5 | 101.8 102.0 | 102. 0 | 103. 0 102. 4 102.7
Taper se eee eral win a, TIO, Dilley eee| 10254 Eee 10 25Gi eee 102. 3
Sip Me sees <i 102.1 101.8 102.4 102.1 | 102.4 102.6) 102.8 | 102.2
eM t= sieceers Soa See ects Sek OW Sy ise see ad UGRBW inseacsedes | 10264 eee 102. 2
HOP SMe cee ONES) SBR emacs 102.0 |.--..-- =. HO2B \sessecosce | TOPE) laseoosasac
IVOSTING sated nacaaballapscseaeG al detaessece Maen aces eeeee eee atesaaeen (ees mesos [Rtas eel peers eae
12 midnight.....--. Inj.tubereulinS, | Inj. tuberculin 8. | Inj. tuberculin S. | Inj. tuberculin 8.

74

Temperature as taken before and after the injection of tuberculin—Continued.

305 308

Hour. May 25. | May 26, May 25.
Before | After Before
injection. injection. injection.

hee tS SeaPopo ey eee Lae domese LOE Glcp aaceses 101. 2
Sane ee ote | 100.8} © 101.7 101.8, = 101.6
Ooo eet eee ar |nwb nce s cies LOLS) eee eee ! 101.4
LO a nee a seasons 100. 6 101.1. 101.4 | 101.4 |
Uae ae se IS omens. LOLS ianeereees 101.4 |
PA MOON A= cieiere > 22 | 100. 6 101.4 101.3 101. 4
I hi taeda saeco Weleogs 3: AD: Geese mete 101.4
Qieeklte ae aretea oon | 100.9 101.8 | 101.3 101.6
Site sist ae ects | bap eae Sr a eae Sa {ede G
AD Miz lsre.s'e siete = Ss | TOMB UIEN cere es LOM GR seers
lund Naan eiocm ons onesie eo HDB On nearer |= 102.7
(i Rat eeeaasaos 101.6 | 103.0 | 102.4 1038. 0
TAPAS o cei es sae oe oe eee TORSO IS oe ee 103. 0
Spas ssesescee 101.4- 102.0 102.2} 102.7
ae ADS PRE Wiha 9 1A 101. Bos eteecwse | 102.6
Wp oahiie toe. ae oe BOS |o22 5 ee TOTO" |. Soveees es
12 midnight bse othe Inj. tuberculin S. Inj. jateeatn Ss.
319 320
Hour. May 25. | May 26, io 25. | May 26.

| May 26.
After

309

315

Galen 25. | May 26.
Before After

| May 25. | May 26.
| Before | After

are tien. Fee injection. linjeetion. ‘injection.

i es or 101.

4} cee 104.0
fs 70226 101.5} 101.8 | 104.6
Pal tenes 101. 6)|. eee 104, 4
101.2 101.2} 10.4 105, 2
eeiaieen ue 101.0 |oceeeeeee 105. 2
101.3 100.8; 101.2 105.3
Peseta 101.0: |: ee eters 104.7
101.3 101.2 |» 101.4 104.6
en oop 101.2: |: cee een 104.3
101. 8.|.2522.... | 202i eee
Btoee ee 102: 5) | Sees 104. 6
101.5 102.6 | 102.8 | 104.5
Saecte 10D. cA |e eee 104.2
101. 6 102.2. |. essay 104.0
Sa eee eae 101.87) eee 104.0
1012 vee eee | ROS AGES) arene

Inj. tuberculin 8.

| Inj. tuberculin S.

May 25. te 26.

| May 25. May 26.

Before Alter | Before After | Before | After | Before After
injection. eperneu: | injection. injection. injection. injection. injection. injection.
(EAN Agena Aa onl Gocgonsee NODA Sore OLAS lt eaters 10156; |seieeeseee 101.4
Sig. as22 weenie 102. 7 | 102.5 101.7 101.5 101. 2 101.6 | 101.5 | 101.5
Lb 00 Ope ee esas eee Its jes Senet TOU eee see LOU 2S) Se eee 2 LOLS Sees i 100. 0
UCR le eee sense oe 102.0 101.5 101.5 101.4 101.6 101.4 101.3 | 100.5
IIE eee eeBaneee lteeben abe CE pa eee COLO reenter pee 102.0%): = eee 101.3
T2NOCM Esc eae 101. 4 101.8 101.2 101.5 101.6 | 101.9 | 100, 9 | 101.6
Up SN Se betes sae panes ae LOD OM ee een LOUGH eS 22 Se ee 10178")) eee 102.0
74, THUY RAS ie PSE 101.6 102. 2 101.4 101.6 | 101.5 102. 0 101.2 | 101.9
BD n> Susie oe als tee eee TA) Sil SS Sr Oe ee | HONG ates cete a 101.9 | -coSeae 101.8
Ap GNe ase ceenees 1OSO ORES Os) Sse 0135 aes 101 949|2. eee
Bp lames ee taal see st VOD SG |= -eteseratere « 103.45 [222525 5. = 102./6+|: oa aoa eee | 102. 8
6p mse Aire ne nea 103. 6 102.9 | 102.0 103. 0 102. 0 102.7 102. 2 | 102.4
MD. SAGs” oo eee | eee see O28 8) |S apes oie crete LOZ Gel aes ce at 02564). 2a eee 102.6
Sip. Wiese ces eee 103.5 102.7 101.8 102.6 101.5 | 102.5 102. 0 | 102.5
Opi mss 645 sel Seomee aoe 102363) Sc Seems. 10235) |asoctnes- = 102./2)|. 2 eae ese 102.2
LO Sin jeseese sees TOS! Ol teers | LOUAS i Seeeeeee n= 101. 2 4 52:¢oeeee 1016 |2aeeseee
AT p.m hitiac' ae 2d Seer a eee cere cece |nsala sec ceels cueeee mes] bese Obes cee eee |< 2eee eee

12midnight..-...... Inj. tuberculin S. | Inj. tuberc ulin 8. Inj. tuberculin S. | Inj. tuberculin S

334 336 339

Hour | er 25. | May 26. | May 25.. | May 26. May 25. | May 26.

i" Before After Before | Atter Before After

injection. ejection: inipCHon Ged sir | Geeta
i Gh, Ta FDL ee ae coats aan Rom aerctay NOUN 82] eee Seis ais 10256) eee 102.0
Sal Mend Pe a See eee omens 100. 0 101.8 102. 6 102. 6 | 101.4 | 102.0
ORIN s occ Seis ees eae er eee ee eine eraanatas LOUAON|: Losec cee 102.2 2. aeeeee 101.4
RO fess BS ce mete eee ole roe mie ey ete 100.9 101. 2 102. 0 | 102. 4 | 101.3 | 101.0
Was Wis) ee Bes oe ele es leplor oe eee ee | teemeernere eter MOU 4 Ms te ees oe 102:'8: | 23h eeeeee 101.2
12 MOOR shies ae Oe ee eee eae 100. 3 101.8 101.2 103. 2 100.5 101.0
ADIs Sete ac ear: ho re aA Be ae | 2 MOTB, hs oe ets 103:0)| aan 101.8
iD ANE aha eee ole eee cls Seren any 101.2 102. 0 101.5 103. 6 101.6 | 101.8
SMS sa ond Week eee ee ae ace o ee agee eens LOZ | 2ciseee eee | 103216) |aeeeeeetae 102.4
AD Se ie ceases eae cere pret Se eel GUG a Slerate rae eter LOZNOR) Esc eens O20: |e teptneretete
Spi. ¢. 24 us Soeee eee eee oe eee L027 ||ncinz eae oa 10356 (222th eee 102.6
OPM es nse ao ee eee 102. 2 | 102.4 | 102.9 103.6 103. 0 102. 6
Th le = Se8 oe nk ew te oa eee ee lm AODA Oye een nse 10356:| ae ee 102.5
Cipi Mele elo ee ae ees eer eee 101.5 | 101.8 | 102.8 103.8 102. 2 102.5
Open sss Soot Taek ate ee ee oe eee eee Bo LOUD 4-eecem= Se = 10826. \|\< seers 102. 2
LO primero ch. Sees sees TOD Bio. sesamiae 10226"| 2.2 oeeeee 102. 2 Boo
VA perms sae ek 22 Se Se 2 bw ae shee pela Re Se we rere ee eae | ater sa tara ae ea senses

12) midnight: 5 2.22 22p2 2 anaes cee ee | Inj. tuberculin S. | Inj. tuberculinS. | Inj. tuberculinS.

|

ee

FURTHER EXPERIMENTAL OBSERVATIONS ON THE PRESENCE OF TUBERCLE
BACILLI IN THE MILK OF COWS.

By E. C. ScHroeper, M. D. V.

The following experiments to demonstrate the presence of tubercle
bacilli in milk are a continuation of the observations published on page
60 of Bulletin No. 3, 1893, of the Bureau of Animal Industry.

In the former work the principal question to be solved was the rela-
tion which exists between the condition of a tuberculous animal and
the degree of milk infection. The same question was kept in view in
the present work, but in addition to it some information was sought
concerning the probable extent to which tubercle bacilli occur in the
general city milk supply. Hence the following experiments divide
themselves into two series: The first deals with city milk in the condi-
tion in which it reaches the consumer, and the second, with milk from
cows without visible disease of the udder in which tuberculosis was
diagnosed, either through a physical examination, or through the use
of tuberculin injections.

The milk was injected into the abdominal cavity of guinea pigs
partly in the form in, which it was obtained from the dealer or the cow
and partly after it had undergone a centrifugal process. The latter
consisted in pouring a quantity of milk into glass tubes and rotating it
in them fifteen minutes by means of a small hand centrifugal machine,
which was made to revolve 1,500 times per minute. The fluid in the
bottom of the tubes, together with the sediment, if there was any, was
retained for injection and the balance of the milk discarded. The
object of the centrifugal process was to concentrate, in the smallest
amount of fluid, any tubercle bacilli present. It has been shown experi-
mentally that the conduct of different bacteria varies in fluids subjected
to centrifugal motion. Some bacteria rise to the surface, while others,
and among them the tubercle bacilli, gravitate to the bottom.*

Cover-glass preparations were stained and examined for tubercle
bacilli from every specimen of milk, excepting that from cow No. 283,
but were found in no instance. Multinuclear leucocytes in greater or
smaller numbers were present in the cover glasses from all specimens
of milk excepting those marked dairy H and L. Among the numerous

_ *Scheurlen, Arbeiten a. d. Kaiserl. Gesundheitsamte, vir (1891), p. 269.

‘

o

76

bacteria present a large coccus and a large thick bacillus predominated.
Occasionally streptococci were seen in small numbers.

Nothing was known of the condition of the milk from the dairies and
dealers at the time it was procured for examination, and consequently
some precautions were believed necessary to avoid diseases of the guinea
pigs from the accidental presence of miscellaneous septic or toxic bac-
teria. For this reason the milk injected into the first six guinea-pigs,
which are given separately in Table I, was previously exposed to an
elevated temperature, 60° C., for fifteen minutes. This procedure, it was
thought would destroy the other germs, if such were present, or reduce
their virulence sufficiently to make them harmless, without seriously
affecting the tubercle bacilli. As a control in the heating process a
suspension of tubercle bacilli was made in the manner described below
and injected into the abdominal cavity of a guinea pig.

A small amount of the surface growth on an glycerin-agar culture
of tubercle bacilli was scraped off and thoroughly triturated with 10 ce.
of beef infusion. When the beef infusion had assumed a homogeneous
cloudiness, and no clumps or solid particles visible to the naked eye
remained, 0.5 ce. was removed with a sterile pipette and added to 5 ce.
of milk, which was then exposed to a temperature of 60° C. for fifteen
minutes.

The guinea pig which received this injection was chloroformed after
eighty-five days and on post-mortem examination no lesions were
found. Even before the guinea pig was killed the inference from its
uninterrupted good condition was that the few tuberele bacilli which
might be present in a specimen of mixed milk could not undergo the
heating process without sacrificing their vitality. This view was
further supported by the death of two guinea pigs in twenty-five and
twenty-eight days, respectively, which were injected, shortly after the
first guinea pig was injected, with similar suspensions of tubercle
bacillus which had not been previously exposed to an elevated temper-
ature. Hence after the first six injections, which are given in the
following table, the heating process was discontinued :*

TABLE I.
.
7 : -- | Weight of “4
aoe _Date of Date when | Quantity nea | guinea pig weer | Source of ‘Autonee
* pig ‘ injection. killed. , Injected. San | when injec-| killed milk. | OrSTe
=P | tion made. | ; )
pe Fee DS ee Bs | Shee Sch ge
ce. ce. Ounces. | Ounces. | |
4449 | June 28, 1893 | Sept. 23, 1893 | 5 40 20% | 22 | Dairy 1..| Negative.
M45 Feit dO so eesee Rete lye 4} 5 | 40 | 24 31 |feedoceeer i Dor
4479 | June 30, 1893 |....do . 5 40 14} 18 Dairy 2 -- Do.
448 OD eee Onne eens aE ad Oles satis | 5 | a40 18 22) |. dOlssece Do,
4559 | July 8, 1893 | Oct. 17, 1893 | 5 40 19 203 | Dairy 3..} Do.
456 es se OS aan oes mista 57 ko eee By 40 17 20:9) 2 dOeacee Do.
| | | |

a The 40 cc. here represent the lower strata in a bottle containing 100 ce., which had stood on ice

(fifteen minutes at 60° C.) does not harmonize with the results of others. De Man

(Archiy. f. Hygiene, xvi11., p. 123) finds that at 60° C., one hour is necessary to destroy
tubercle bacilli in milk.—T.§.

(it

The next table gives the results of 40 injections, which represent
19 specimens of milk. The milk, excepting that marked dairy Q, was
delivered to private residences or bought in different sections of Wash-
ington, D. C., and nothing is known about the cows by which it was
produced. Dairy milk Q was obtained from a herd of cattle in Vir-
ginia, numbering twelve milch cows, eight of which gave high tempera-
ture reactions after injection with tuberculin. In twoof the eight cows
tuberculosis could be readily diagnosed on physical examination. The
milk from the twelve cows was drawn in the usual manner at the evening
milking, poured into a large can, and allowed to stand about one-half
hour. The can was then thoroughly agitated three to five minutes and
a specimen of milk dipped out of the top and taken in a sterile bottle
to the laboratory, where it was used for injections the following morn-
ing. ;

The use of the names * dairy” and + dealer” in specifying the source
of the different samples of milk represented in the table is to distin-
guish a dairy or regularly established milk business from dealers with
whom the sale of milk forms only a small fraction of their trade.

The following table records the injection of mixed milk obtained from
the general milk supply of Washington, D.C. The injections were
made into the peritoneal cavity, and the amount tnjected in each case
was 9 Ce:

78

*— quesqe
‘+ qguosoad ! sts
-O[NI1eqny JO 9oue
Seid 10 aoUEsq V

~~ er ew oe ar se eee oe

“BIlo} POE 5,
“OV JO JoQqUINU o[qRLopIsuod ‘soa93A00dN0T mae or o 0 81
OE ate s----"==-qarp pue ‘ermogong ‘sayXoooney | F cee at row) We
San toocccs tts ss s5>=--prI9joug puw sezAoooneT FF ZS 0) rojo) a
-qarp puv ‘sozAo0oneJ ‘vruwajporg | $g Aureq) He
-saq Ad0onog] pur vilaqgorq Jo 1oquinu s[qvaepisuoy | fg Aa eq) te
[eee ee eens a een To) ond) SHOTGUN IO Searhi sareq} ae
P SOSO TS athe mes Cuter -----saj3fd00ne] SNOJOUM NT | 6 POMS: & same) ie
SaaS Somme ~-BIdajgorq Mos BV pue sayAo0one7T | Fe Wa rana are) ag
| | Th ec
| . | fL1
-soyAn0oneT Auvut 10a !yuourpesjzuupunqediaA | $9 I gaa
; mA!
letrena: Cres Soqny ISNJLIy W990 UL YUOTUTPYS ON | FOL SO Sill Suey) eo
5 tii ee ont ater ep sat etal aaaeatit oll 0) «Natalia Coe") “7 9 Lae}
; §) ez
Sipciucige csi ---> BLLayoRG paw sogAoo0one] Mag EL PCE TOIveCLy
, | ¥¢
ute dS eae ied osa male T° Sgn mie oy EES Cae (0) el ainadl tn «4 “gE dopo b's
OCCT pl go erase Etat OL baat seat (1) hie rat "77> qt Aare} a
Sr Shh ima Ae BLLOORG puB so}ADOONAT SHOdoUMN 9 SOAs sowoat} Bee Fd
| 0G
sao VILE}OVG SHOAEWINM ‘yuatITpes FSI[S Ato, OT Bs are) "3
roses sss-ss-=se9yK900n0T MOF B S4yMeMUTpaS FYSTS OL ee Aareq) =
“SadUNG
“yuu .
‘ “soquy osnsLIyWao Jo 00 sed > [ru Bott
UL JUOULLpas JO WOTPVULMIeXS DICOOSOLOL TAL | urvado JO) JO goaneg at ti
| unto, Teo AN
"II @IAV EL

|
|

cL OD aap nar Ope tr cree - Afor
raat Av | F68L°6 3 0L
ral
rat
Ya
Zl
1
cl
91 ODN a2 sess OBER aE teens ae “-- Pgs
iat Onis
0 op
eT ODies
LT eee nO Dae or
tI | F681 ‘c Av | F68L
61 ieee panes a I Soe ope
SI OF | F681 ‘FL “ad yw
he BFE GOFER ere ocala) obhee
. “FOS
SI OF g ‘ady perq -
81 ph giake ery fe OD ARs | p
91 OF FEST ‘PL “wd y | F6Rl ‘LE “URL PEL
61 eke Aare ee pal ons at ag Op eers ner te Sal OP ae eat att ko eas | Y OLF
91 OP aa [oo seens (OPORE SEN tle cell ls be eee SS P69F
0z Sse eae TGS TE Te tO sara Opa linens aes eae ~ Por
"S681 ‘ST | eet
Bee OF ‘ony peld | S6si ‘8c Ane
at Jere... wcilenese-.gpetssj-eent == op
sI ORGAN Pain op’--> €68L "0 Ane
1 | ee des po Naas cS Ss SO AE ORS oe Tog ODE er
0% or e681 ‘Te “FO esl ‘6r Ane
| _ ‘8681 |
Pee 9 UY 0 ns ODEea a
s>7-->- op-* ="! eggq ‘eT AINE
o ee Op ate Crees! Jeans
wee op-***| $681 ‘FT Ame |
VE ae a, Be OPPS | see a ODE |
91 | OF €680‘2T “YO 6ST ‘Zr Ane |
“saOUNGO | "00 |
| |
“epeuL
uor}oefat fies COU “pert “uorjo9 (OL ‘sold voutns jo
juoya Sd) pazres Ot case jo oyRq” X08 pau Goniaiks

BIUING JO -NFLIZWAD |
JUSTO AA

19

‘osud IxeU Gas SojOU WojJ10M-ysod OT »

| |
Ene ela thn eae ee eee TT StTMopaed [wxoues) ec Sra Naren oer ener italy atc heaton eee
Si ee SAOde S¥ OURS HOTFeUTMLXE OIdoODSOINIIT | FT eS sare} ue se |
Tuas meee) pee AGT eo ae
virejorqg pur selAoooney] Jo doquinm ofqvaseprs 91 “--- y Aareq), 61 ane
-109 B !1oyjeUL SHOydIoMIe JO JUNOMIe oscILT yS) | 80 1 $9

F681
Te ady ped

opi-|tceo
FEST ‘et Ame] P6816 “Idy

80

Guinea pig No. 462 died of general peritonitis two days after the injection.

Guinea pig No. 467 died of general peritonitis eighteen days after the injection.
An abscess about one-half inch in diameter had formed at the seat of injection on
the inner surface of the abdominal wall; this had ruptured and discharged its con-
tents into the abdominal cavity. Cover glasses from the fluid in the abdominal
cavity showed the presence of cocci in considerable numbers.

Guinea pig No. 75 died of tuberculosis sixty-three days after the injection. There
were tubercles on omentum, a large tuberculous spleen, and large yellow necrotic
patches in liver. Glands behind stomach and spleen very large and necrotic.
Sternal and bronchial glands quite large, firm, necrotic. Lungs flesh red; much .
serum in pleurai cavities. Scattering subpleural tubercles on lungs.* Cover glasses
from various regions showed an abundance of tubercle bacilli.

Guinea pig No. 93 was affected with a disease the nature of which was not
recognized. ‘The autopsy notes are as follows:

Liver, pale in color and sprinkled with small, irregular, grayish or yellowish-
white foci. Spleen enlarged to five times its normal dimensions and containing foci
similar to those in the liver. The kidneys appear as two large, white tumors; on
section they are seen to be more or less completely degenerated.t No tubercle
bacilli or other germs detected in cover-glass preparations.

We sce thus that among the 19 specimens of milk obtained from the
general city milk supply, one contained the bacillus of tuberculosis in
sufficient numbers to produce the disease in one of the two guinea pigs
injected with it. Why one guinea pig should have remained unaffected
is an unsolved question. The guinea pig which died of tuberculosis
was injected with the milk in the form in which it came from the dairy,
while the guinea pig which escaped the infection was injected with a
specimen of the same milk which had previously been subjected to the
centrifugal process. In this connection it must be remembered that
the amount of milk which can be injected into the abdominal cavity of
a guinea pig with any degree of safety is very small.

We may summarize the results recorded in Table II by the statement
that now and then the mixed milk of dairies may contain compara-
tively large numbers of tubercle bacilli. In the foregoing series one
out of 19 samples from different dealers or dairies contained tubercle
bacilli.

Table III gives the results obtained by the injection of milk from
cows in which tuberculosis was diagnosed either with or without the
aid of tuberculin. .

The milk was collected 1 sterile bottles, and, with the exception of
sainples from cow No. 283, represents a mixture of the product from all

* A careful examination of the lesions in this animal showed that the infection
started from the abdomen and was due to the milk injected. The guinea pigs used
in this laboratory are bred on the experiment station. Spontaneous tuberculosis
has never been found in any case.—T. 8.

+The disease in this guinea pig might be mistaken for tuberculosis. It differs
from the latter, however, in the restricted, irregular size of the minute foci and the
disease of the kidneys, which are almost invariably normal in tuberculous
guinea pigs. The microscopic examination of the kidneys showed an extensive
interstitial nephritis. The foci in the liver are situated in the interlobular tissue,

4

and consist of infiltrations of round cells.—T. 8,

81

four quarters of the udder. The milk from each quarter of the udder
of cow No. 283 was drawn into a separate sterile bottle. Guinea pig
No. 33 was injected with the milk from the right forward quarter, No.
34 from the left forward quarter, No. 35 from the right hind quarter,
and No. 36 from the left hind quarter. :

2891—No. 7-——6

82

‘ased 4xou 998 eou TeLoeds IO ,

eas * Ras eae heel ae hae pater | mY ; Be in Ste heme a aA, ee |g a
cae ; trorssssseesssee=s= gga Cooong] JO SlOquINU osIe'T [Ep 8'A\ oN nog) OT oh il Paley F68T'Z ae BS Sub ae ee ee
a eee ee Ne ee aha) See ee ee cee cen wate cnn scl yas ST Tor OP or es op: a vOD eile oat eth
= } PE 06 eM oN 4100) OT | OL EO ae ee edo ee Co} Ua t= = Salieri! ek Se re Bemba
= , Tee as Saat hae Soe sopAooone] MoT EL GAN ON. sop} 1B | - bs ee See ate) Sass canes
on Saar eee eee ok 3 § nate S| &% Fer OR Ker Trees ODE TE te op" -""
mee } sejA00ong[ JO Laquinu es1eyT fo I'M ‘ON ed IT | ZI Soscesnn sl Peat eG ACI PERL 6 lon
= Brel titaie dae OE OCR EERE Cc eee air SNe abobese ct Senay, $| 9 | OL op op---
= op | GLB “ON 8099) OF “FI op: op:
te Baie tetetele ta ta) aye reeds Benmcosongc dee ROACaOO Pose Gy ya oone [Baap tate: Gane 4 om) £ | 1 op:- ODEs 5
ms } rere) | 912 ON W095] OF | oT op: = oe
= Vestaapers a sated aeons BACH ZHOU oS ood bea SEW EO cOaE Hoe De scrod Snes §} LT a! op: op >"
- } op----""| ELZ'ON MOK) OF | et ane Gtr
et b accsees--2+---gqAo00n9] aay te AyUO “BELoJOUG ONE |7777 77777" -7-g9g “ONT ODS ie pe el eaaiivt autre ear
a ee les Sash oh CI oot cya ot eee pan
me Firs ae gate “PoULMRXO Y[LUL WLOdJ SOSSBLS TAAOD ONT [>>> 7777777 --"€8g "ON MOD pee Ag Sal oarae iste eure Sees | nee
a | | met hax COU dbus aie oy FEST ‘OT “AVI | S681 ‘GT “Ved
== } EL ema een te PRT LA a ODE Ak “---]---622 ON s109)5| ag iL :
= Soe esencose ben cdee Bor Bot eC RE Lee SA ee anets 5 z :
= OlPrqaraee eee op 912 ON 09), 16 a
5 | en > °
=a i eet hse Pike ae oa gear sae? terest Oper) srrseeerss|---gyg "on mons! ag i F
Sabee pics Coa Sings cae aaa ae ieee “71g ON mop,| 0% 43
es eee veeeeeeetecens ee opsssrr[eseseeeeee]e econ mops OF dese as one Te
TEES et Pere ; ae SR tiered eee | Sel a ce Sa n)|_06 cG OF Fee tao) 0)r = OCC (yao
393 A900n I nu [TB 2 ‘RLLagoRq 0 2
~ 5 Pea EL eres gree CAE egies et kee Ree ee SP tlkae 8 sees FEST 'LG “MO | E681 SG “AON
"sa0Un(G) | *saaUNng | 00
~ = ——— fs =: aS Ses te — nn = [eee | -
, ‘opeuL

“(= guesqe ‘+ “WIE Jo a tA fe ae |

qgueseid) stsoTno ‘soqny oSnjta1y OO, sed “ypu pot jouer Bo *P2TLOL ‘uoroofur | “std vous jo

-1aqny JO 9oue U9) UL JUeUIEpes JO UOTVULMIBXe oTdOOSOTOT_ | UNBeA0 JO JO 90an0g an Me eevee oe oe es ueyM ayeqT | jyoojyeq | xes puv coquinyy

-soad 10 99008 ¥ ano A TAATOM | need ies Sc

‘hiyvwa poauoptuad ayi 0p WL apo auan aspa yova ur
00 G fo SWwOYdalUT —WOLpOVIL ULtpnadagny aayrsod VY aAaMhH Yoryn LO SNO]NIMAQn) Aq 07 WROUY LaYpLa aan Yyorymn snoo wowf ypu fo woyoalur ay) Hurp..ovad 2)QDT,

TI] VIavyL

83

Guinea pig No. 35 was found tuberculous when killed. The dorsal third of the
spleen was infiltrated with tubercles, probably by contiguity from the lymph
glands associated with it, which are much enlarged and necrotic. The left testicle
is converted into a thin walled sac filled with a thick, yellowish pus, resembling
flour paste in consistency. Tubercle bacilli present in cover glasses. A guinea pig
inoculated witha particle of spleen pulp became tuberculous.

On post-mortem examination cow No. 283 was found to be extensively tuberculous,
but the udder and pubic lymph glands were found free from tubercular lesions after
a very careful naked-eye examination.

The second series of inoculations thus include the milk from 12
tuberculous cows, from three of which injections were made at two differ-
ent times sixty days apart. The milk from only one cow, an animal
practically in the last stages of more or less generalized tuberculosis,
produced the affection in one of the four guinea pigs injected with it. -

In addition to these experiments, a third series was tried by injecting
repeatedly into a number of guinea pigs the milk of the same animal.
It was assumed that by increasing in this way the quantity of milk
injected into the same guinea pig from the same cow more positive
results might be obtained. The milk was injected directly into the
abdominal cavity in every case. When centrifugalized, the quantity
injected was derived from 40 ce. (15 ounces).

MILK FROM COW No. 286.

This cow is in the last stages of tuberculosis, but has no visible attection of the
udder.* See No. 286, Table v, p. 144.

Guinea pig No. 1462.

March 16. Weight of guinea pig, [3 ounces; injected 5 cc. centrifuge milk.
March 19. Weight of guinea pig, 134 ouncess injected 5 cc. centrifuge milk.
March 24. Weight of guinea pig, 14 ounces; injected 5 cc. untreated milk.

April 4. Weight of guinea pig, 142 ounces; injected 5 cc. untreated milk.

April 12. Weight of guinea pig, 114 ounces; no injection.

Up to the time of the last injection, on April 4, the guinea pig remained in good
condition, and had been gradually gaining in weight. On April 18 it was found in
a dying condition, and was killed and examined. Extremely emaciated. At the
seat of one injection a small abscess, containing pale yellow pus. Similar abscesses,
not less than a dozen, varying in size from a mustard seed to a pea, in the abdominal
cavity. Adhesion of the liver to the abdominal wall and the stomach. Cover
glasses show the presence of a coccus in considerable number. t

*For the extent of the disease and its distribution in this animal, see No. 283,
Table v, p. 144. — T.S.

+The lesions in this and other guinea pigs which were inoculated with milk from
cow No. 286 were evidently due to Staphylococci in the udder. The lesions included
peritonitis, suppurative pericarditis, and multiple abscesses in the internal organs of
those guinea-pigs which died prematurely, and firm adhesions of liver, stomach, and
intestines to neighboring structures in those that recovered. Staphylococci were
isolated from the milk directly and from one of the guinea pigs. This subject will
receive more attention.—T, 8.

84

Guinea pig No. 1479.

March 16. Weight of guinea pig, 11 ounces; injected 5 cc. centrifuge milk.

March 19. Weight of guinea pig, 11 ounces; injected 5 ce. centrifuge milk.

March 24. Weight of guinea pig, 11 ounces; injected 5 cc. centrifuge milk.

March 26. Dead.

Marked injection of the veins of subcutis over the abdomen. Whitish discolora-
tion of abdominal muscles at the seat of injection. Extensive viscid exudate in the
abdomen. Fseudo-membranous deposit on spleen and liver, with whitish clumps
intermixed. Hyperemia of lungs with viscid, translucent pleural exudate.

No bacteria in cover glasses from abdominal exudate.

Guinea pig No. 15492.

March 21. Weight of guinea pig, 114 ounces; injected 5 cc. centrifuge milk.

March 24. Weight of guinea pig, 11 ounces; injected 5 ce, untreated milk.

April 4. Weight of guinea pig, 11 ounces; injected 5 cc. untreated milk.

April 12. Weight of guinea pig, 94 ounces; no injection.

April 23. Weight of guinea pig, 10} ounces; no injection.

July 13. Weight of guinea pig, 19 ounces.

Chloroformed and examined post-mortem. Firm adhesion of liver to diaphragm
and stomach.

Guinea pig No. 1559.

March 21. Weight of guinea pig, 144 ounces; injected 5 cc. centrifuge milk.

March 24. Weight of guinea pig, 154 ounces; injected 5 cc. untreated milk,

April 4. Weight of guinea pig, 15 ounces; injected 5 cc. untreated milk.

April 12. Weight of guinea pig, 15 ounces; injected 5 ce. untreated milk,

May 1. Died this morning.

The abdominal cavity is filled with a turbid reddish fluid. In the liver is a large
abscess which is filled with a dirty vellowish red fluid. What is left of the liver
tissue is soft and mushy in character, dark red in color, and sprinkled with minute
necrotic areas. The intestine is adherent to the abdominal wall and the stomach
to the abdominal wall and liver. The entire thoracic cavity is filled with a turbid
reddish fluid, -vhich coagulates slowly and forms a soft gelatinous clot. Lungs in a
state of extreme congestion and very edematous. Heart with the pericardium
adherent. Between the heart and the pericardium, one small abscess. One small
abscess between the skin and the abdominal wall.

The condition of the cow had been growing rapidly worse and had reached a stage
at the time these injections were undertaken which would have led the average
dairyman to exclude her from his herd.

Guinea pig No. 187 2.

May 5. Weight of guinea pig, 184 ounces; injected 5 cc. untreated milk. .

May 19. Weight of guinea pig 174 ounces; injected 5 cc. untreated milk.

May 24. Weight of guinea pig, 174 ounces; injected 5 ce. untreated milk.

July 15. Weight of guinea pig, 16} ounces,

Chloroformed and examined post-mortem. Adhesion of liver to stomach, and .
intestine to abdominal wall.

Guinea pig No. 188 8.

May 14. Weight of guinea pig, 244 ounces; injected 5 ec. untreated milk.
May 19. Weight of guinea pig, 254 ounces; injected 5 cc. untreated milk.
May 24. Weight of guinea pig, 253 ounces; injected 5 ce. untreated milk.
July 18. Weight of guinea pig, 28 ounces.

Chloroformed and examined post-mortem. No lesions.

85

Guinea pig No. 1892.

May 19. Weight of guinea pig, 124 ounces; injected 5 cc. untreated milk.
May 24. Weight of guinea pig, 123 ounces; no injection.

July 13. Weight of guinea pig, 19 ounces.

Chloroformed and examined post-mortem. No lesions.

MILK FROM COW NO. 285.

This cow gave a marked tuberculin reaction, but is in fairly good condition and
has no visible affection of the udder.

Guinea pig No. 1489.

March 16. Weight of guinea pig, 134 ounces; injected 5 cc. centrifuge milk.

March 19. Weight of guinea pig, 14 ounces; injected 5 ce. centrifuge milk.

March 24. Weight of guinea pig, 14 ounces; injected 5 cc. untreated milk.

April 4. Weight of guinea pig, 14? ounces; injected 5 cc. untreated milk.

April 12. Weight of guinea pig, 14 ounces; injected 5 cc. untreated milk.

April 16. Weight of guinea pig, 15 ounces; no injection.

July 13. Weight of guinea pig, 23 ounces.

Chloroformed and examined. Adhesion of the intestine in two places to the
abdominal wall.

Guinea pig No. 1499.

March 16. Weight of guinea pig, 153 ounces; injected 5 cc. centrifuge milk.

March 19. Weight of guinea pig, 15 ounces; injected 5 ce. centrifuge milk.

March 24. Weight of guinea pig, 132 ounces; injected 5 cc. untreated milk.

April 4. Weight of guinea pig, 14 ounces; injected 5 cc. untreated milk.

April 12. Weight of guinea pig, 13} ounces; injected 5 cc. untreated milk.

April 23. Weight of guinea pig, 144 ounces; no injection.

July 15. Weight of guinea pig, 22 ounces.

Chloroformed and examined post-mortem. Adhesion of stomach and intestine to
liver.

Guinea pig No. 1569.

March 21. Weight of guinea pig, 144 ounces; injected 5 cc. centrifuge milk.

March 24. Weight of guinea pig, 144 ounces; injected 5 cc. untreated milk.

April 4. Weight of guinea pig, 15 ounces; injected 5 cc. untreated milk.

April 12. Weight of guinea pig, 154 ounces; injected 5 ec. untreated milk.

April 13. Found dead.

On post-mortem examination a number of whitish clumps (probably casein) were
found in the abdominal cavity between the coils of intestine and sprinkled over
the liver, spleen, etc. A considerable amount of pale red, partly translucent, fluid
in the abdominal cavity. General discoloration of the abdominal wall and serous
surface of the intestine.

Guinea pig No. 1579.

March 21. Weight of guinea pig, 103 ounces; injected 5 cc, centrifuge milk.

March 24, Weight of guinea pig, 93 ounces; injected 5 cc. untreated milk.

April4. Weight of guinea pig, 10 ounces; injected 5 cc. untreated milk.

April 12. Weight of guinea pig, 94 ounces; injected 5 cc. untreated milk.

April 18. Found dead this morning.

Autopsy revealed the same condition asin guinea pig No. 146. There was, in addi-
tion, a collapsed and cedematous condition of the lungs and a purulent pericarditis.

i

86

MILK FROM COW NO 290.

This cow is supposed to be in an advanced stage of tuberculosis. She has given a
reaction upon injection with tubereulin several times. but has no visible udder
affection. :

Guinea pig No. 183 g

April 18. Weight of guinea pig, 13 ounces; injected 5 cc. untreated milk.

April 23. Weight of guinea pig 144 ounces; injected 5 cc. untreated milk.

April 28. Weight of guinea pig, 15 ounces; injected 5 cc. untreated milk.

May 5. Weight of guinea pig, 16 ounces; injected 5 cc. untreated milk.

July 13. Weight of guinea pig, 23 ounces.

‘Chloroformed and examined post-mortem. Slight adhesion of intestine to abdomi-
nal wall.

Guinea pig No. 184 g.

April 18. Weight of guinea pig, 114 ounces; injected 5 cc. untreated milk.
April 28. Weight of guinea pig, 13 ounces; injected 5 ec. untreated milk.
May 5. Weight of guinea pig, 14} ounces; injected 5 cc. untreated milk.
July 18. Weight of guinea pig, 15 ounces.

Chlorotormed and examined post-mortem. No lesions,

Guinea pig No. 185 9.

April 23. Weight of guinea pig, 104 ounces; injected 5 ce. untreated milk.
uly 13. eight of guinea pig, 12 ounces.

July 13. Weight of g g, 12

Chloroformed and examined post-mortem. No lesions.

MILK FROM COW NO. 291.

This cow showed the presence of more or less t uberculosis on post-mortem exami-
nation, but had no visible aftection of the udder.*

Guinea pig No. 186 2.

April 23. Weight of guinea pig, 13 ounces; injected 5 ce. untreated milk.
April 28. Weight of guinea pig, 13 ounces; no injection.

July 13. Weight of guinea pig, 15 ounces.

Chloroformed and examined post-mortem. No lesions.

Guineas pig No. 158 9.

April 18. Weight of guinea pig, 12 ounces; injected 5 ec. untreated milk.

April 23. Weight of guinea pig, 124 ounces; injected 5 cc. untreated milk.

April 28. Weight of guinea pig, 15 ounces; injected 5 cc. untreated milk.

May 5. Weight of guinea pig, 14 ounces; no injection.

July 13. Weight of guinea pig, 17 ounces.

Chloroformed. I xamination negative.

Tuberculosis was not found in any guinea pig in this last series of
injections, notwithstanding the fact that the 4 cows furnishing the
milk gave a high tuberculin reaction and are to all appearances in an
advanced stage of the disease. Nos. 286 and 291 have been killed and
found tuberculous (see Table v, p. 144).

The inference which may be drawn is the same suggested in Bulletin
No. 3. It is that a careful inspection of all dairy herds which has for

~ See No. 291, Table v, p. 144.— T.S.

87

its object the detection and removal of all advanced cases of tubercu-
losis, and especially of cows with diseased udders, would probably
exclude the sale of most infected milk.

In this connection it may be worth while to mention that in a recent
inspection of over 800 cows which belong to different dairy herds of a
large city it was found that between 5 and 6 per cent of the animals
had defective udders. In the majority of cases it was evident that the
udder trouble was due to present or past affections other than tuber-
culosis, but in the remaining cases this could not be determined during
life.

These experimental observations further show that now and then the
presumably mixed milk of dairies may contain enough tubercle bacilli
to prove fatal to guinea pigs in two months.

STUDIES IN BOVINE TUBERCULOSIS WITH SPECIAL REFERENCE TO
PREVENTION.

By THEOBALD SMITH.

[Plates I-v1.]

Tuberculosis among domesticated animals, more particularly among
cattle, has during the past few years received a large share of attention
mainly because of the possible direct influence on human health. With
this idea in the foreground the bearing of this malady on agricultural
interests has been more or less obscured. As a result we have a great
mass of publications on the hygienic aspect of tuberculosis and but
very little on the prevention of this disease among cattle. Many of the
more valuable contributions to our knowledge have been made in order
to define more definitely what degree of tuberculosis makes an animal
unfit for human food. This point of view, while bringing out now and
then valuable facts, does not pay sufficient attention to the animal dur-
ing life. What to do in order to reduce the high percentage of infec-
tion among living animals has been tacitly ignored in all but a few
recent publications. It became evident to the writer on beginning
these studies that this was, after all, the most important aspect of the
serious problem of bovine tuberculosis. If the disease can be restricted
and repressed among cattle during life the hygienic problem will take
care of itself.

To attack tuberculosis as it exists at present is undoubtedly a most
difficult problem and the conditions which tend to repress or to aug-
ment its further dissemination are very complex. No single measure,
however sweeping, is likely to be successful. A number of details
will have to receive careful attention and, in the end, the success will
depend largely upon the amount of intelligent watchfulness constantly
exercised in various directions by the stock owner. The wide dissemi-
nation and the localized intensity of this disease will require, above all,
concerted action in attempts for its repression. Though a strictly bae-
terial disease and introduced into the body only by the tubercle bacil-
lus, which is always derived from some preéxisting case of disease,
tuberculosis differs, nevertheless, from most animal diseases in very
important particulars. Its unknown beginnings in the body and its

slow insidious march after it has once gained a foothold are responsi-
88

89

ble for the existence of a large number of tuberculous animals in
all stages of the disease. In the earlier stages, while the disease is
still restricted to a single focus, the animal is to all outward appear-
ances in perfect health. It is only after the infection has invaded
several cavities of the body or produced mechanical obstructions that
it becomes manifest. The prolonged latency of the first stage of the
disease with little or no discharge of tubercle bacilli raises the question
what should be done with such cases. A comparison with some other
infectious diseases makes the predicament all the clearer.

When an animal becomes infected with anthrax or with Texas fever
the specific microdrganisms begin to multiply at once. Within twenty-
four hours in the case of anthrax, a few days to a week in Texas fever,
the symptoms are fully developed and death or recovery speedily fol-
lows. There can be no question here concerning degree of disease or
utility of the animal during the earlier stages. The infected and the non-
infected are divided by sharp unmistakable barriers. In tuberculosis,
on the other hand, the infected animal is practically well during the
earliest stages of disease, and the disease may become stationary, pos-
sibly healed. This peculiarity in the nature of tuberculosis modifies
to a certain extent the usual measures employed to repress an infec-
tious disease. In certain diseases the necessity for the destruction of
all infected animals becomes imperative, because the disease must be
kept restricted and suppressed as soon as possible. The present wide
dissemination of this disease and its prevalence among other domesti-
cated animals, such as dogs, cats, horses, goats, and, above all, its
prevalence among man, makes the complete extinction of this malady
an unrealizable problem.

It is largely due to these peculiarities that tuberculosis has received
so little attention until recent years. Its unrecognizable beginnings
and slow insidious march in the body made it appear on the surface as
a disease not of infectious origin, but as one in which inheritance
played an important part. After the discovery of the true cause in the
form of a bacterium (Bacillus tuberculosis) by Koch the conception that
infection played the most important role has gradually gained a firm
foothold. Without in any way wishing to eliminate the factor of hered-
ity, the writer has based the statements in the following pages entirely
on the principle now universally recognized, that without the presence
of the tubercle bacillus there can be no tuberculosis. If it can be
shown that the tubercle bacillus can be kept away from eattle by
adopting certain precautionary measures the discussion concerning
heredity would be useless. If, however, this should prove to be impos-
sible the problems of breed, heredity, and environment, or, in other
words, the accessory causes, will require renewed study.

In the following chapters matters of technical importance are intro-
duced in order to form a basis upon which to found the practical sug-
gestions given at the close. These suggestions must be considered as

90

subject to change as investigations progress. The prevailing ignorance
upon certain important aspects of the subject makes the publication of
even fragmentary researcbes justifiable at the present time.

PRIMARY DISEASE OF THE LUNGS AND PULMONARY GLANDS
(AIR INFECTION),

According to published statements of most authorities and our own
observations tuberculosis of the lungs is the most frequent of all the
primary forms of this disease in cattle. The absence of disease else-
where in the body, or the character of the pulmonary disease itself
when associated with tuberculosis of other organs, leads directly to the
inference that the bacilli must have entered the lungs in the inspired
air. Infection through the air is, therefore, the most serious problem
to be dealt with. It takes place when the tubercle bacilli have become
thoroughly dried, so that they ean be carried like particles of dust in
currents of air and drawn into the lung tissue through the air passages.

In discussing tuberculosis of the lungs we have two forms to deal
with: (1) Disease of the lung tissue proper with disease of the corre-
sponding lymph glands, and (2) disease of the lymph glands of the
lungs without any traceable lung disease associated with them. Tuber-
culosis of the lung tissue is in perhaps 99 per cent of the cases associ-
ated with tuberculosis of the corresponding lymph glands, while disease
of the latter without visible lung affection is quite common in the early
stages of the disease.

TUBERCULOSIS OF THE LUNGS.
(Plates 1, 11, Ir, and tv.)

The earliest disease in the lung tissue is quite regularly located in
the large caudal lobes. The other lobes are occasionally found diseased,
but there seems to be no place of predilection excepting the lobes
mentioned.* Thus, in the herd described in the first article there were
19 cases of lung tuberculosis. Of these—

The large caudal lobes were affectediin=-- 2.2.2. 225-2. 2-5 en eee 16
They were affected exclusively in’. .....:.:.--s2+- <2. -2--->5)ess eee li
Both caudal lobes affected in232.-.-—2-2=ec0 --0- 6-2 26> +e eee 5
Left caudal lobe alone in! --. 2. 2-22. . 2225s Jae ce os ee ces ee
Right: caudal lobe’alone. in) (£22. 2.22 225. eee 5s cee ee eee eee 5
Right cephalic lobe affected im): 225s. 2222 acer eaies Senne = ele eee eee 6
Right cephalic lobe affected exclusively in........-.....--..-----------= 3
Left ventral (with other lobes) im:. 22. 2. oa seee esos soe eee eee 1
Right ventral (with other lobes) im. . 2... <2. uec-m-«s~s- 002s ses ee 1

Left cephalic:(with other lobes) n= -5-555-225 oes. 2-2 eee ee eee 1

* For the nomenclature of the tobes of the bovine Inngs as used in these pages,
see Pl. Land 11.

91

In another herd comprising 9 cases of lung disease only 2 had other
lobes, in addition to the large caudal lobes, affected. In a third herd,
in which pulmonary tuberculosis was found in 6 animals, all had foci
in one or both caudal lobes and only 2 of these had other lobes affected.
In most cases both caudal lobes are involved. In those in which but
one is diseased the left seems to be more frequently attacked.

This predilection for the larger lobes seems to be due to mechanical
conditions. The two main bronchi which supply these lobes branch off
from the trachea at an acute angle (see Pl. 111). The course of the
current of air passing along the trachea into the terminal bronchi is
nearly straight. But, what is of more importance, the caudal lobes are
more expansible than the smaller anterior lobes. This is evident from
the construction of the thorax, as well as from an inspection of the
lungs themselves. The pleura is denser, often wrinkled, over these
lobes when collapsed, a condition which indicates marked stretching
during the expanded state of the lobe. More air passes into the lobes,
and the current may be of greater velocity than that entering the
smaller lateral branches. Tubercle bacilli suspended in the entering
current are thus carried directly into the main bronchi and deposited
in them or their ramifications within the caudal lobes. There they set
up disease somewhere near the main bronchus. In fact, the larger
number of primary foci are found in that portion of the lung tissue above
or dorsad of the main bronchus, i. e., in the portion of the lung tissue
which rests under the ribs at their vertebral-attachment. This portion
is shown as a Shaded area in Plate I. The foci are rarely directly con-
tiguous with the main bronchus or its large branches, and in case of
many the writer was unable to trace any air tube into or near them.

The caudal lobes, as the chief primary seat of pulmonary tuberculo-
sis, are not more susceptible than other lobes. ‘Their infection is solely
due to the fact that tubercle bacilli are deposited in them rather than
in other lobes. Immunity of any region of the lungs is not deducible
from the writer’s observations. As the disease advances it seems to
become equally destructive in all lobes attacked as soon as baeilli have
found their way into them. If, in fact, the writer should predicate
greater susceptibility of any region of the bovine lung, it would be the
ventral and cephalic lobes, especially the former. For, basing our-
selves on the condition of lungs far advanced in tuberculosis, it would
seem that these smaller, less expansible lobes are more severely involved,
when once attacked, than the caudal lobes. This condition would be
analogous to that prevailing in human lungs.

Pulmonary tuberculosis differs from the sporadic forms of broncho-
pheumonia in that the lesions of the latter, like the pneumonias of
swine, are governed in their distribution by gravity. The ventral
lobes, so rarely the seat of earliest lesions in tuberculosis, are affected
first in broncho-pneumonia. Thence the disease spreads upward, over-
flowing into the cephalic lobes and the contiguous portions of the

: 92

caudal lobes. Another characteristic of broncho-pneumonia not found
in tuberculosis is the symmetrical affection of both lungs. This is also
a result of the gravitation of infectious matter. The difference is due
to the mode of infection. The bacteria of swine plague and bovine
pneumonia are speedily killed by drying, and hence dead when in a
condition to be carried in the air. They are not inhaled in the living
state, but are carried into the lungs in fluids and catarrhal secretions,
and thus come under the influence of gravity in their distribution, as
suggested. A comparison of these pneumonias thus indirectly sup-
ports the view that tubercle bacilli are inhaled.

After the development of a primary focus of disease, other foci may
appear as a result of repeated infection from without. It is not an
uncommon thing to observe a number of disease centers, evidently inde-
pendent of one another, in the same lung or even the same lobe. These
foci enlarge and invade neighboring tissue. Having reached a certain
age, the necrotic tissue becomes softened and dischargesinto a bronchus.
Thence the discharged masses, with the contained virus, may be carried
along the air tubes into other regions of the lungs, or, perhaps into the
throat, where it may be swallowed or,thrown outward. This upward
discharge of tubercle bacilli is indicated by the formation of tubercles
on the mucous membrane of the air tubes. Primary disease in this
situation has not been observed in any case examined.

The settling down and multiplication of tubercle bacilli in the lung
tissue seems to be quite independent of any preéxisting disease of the
lungs. In about 150 cases examined only a very few showed pneumonie
lesions or bronchial affections, and in these few cases these changes were
either due to the gravity of the tuberculosis or else to traumatism.
Catarrh of the bronchial tubes was rarely observed, and then only locally,
in connection with a tuberculous focus which was discharging its contents
and causing irritation of the bronchial mucous membrane. On the
other hand, the grafting of tuberculosis upon other lung affections, such
as broncho-pneumonia, is equally rare. There are, it seems, no preéx-
isting pneumonie or bronchial affections which can beregarded as form-
ing the entering wedge for tubercle bacilli. These seem to find in the
healthy lungs a favorable soil at all times. Any special predisposition,
if such really exist, must be sought for in other conditions than those
of visible lesions.

TUBERCULOSIS OF THE THORACIC GLANDS.

There are many cases of tuberculosis which are due to infection
through the inspired air, but which do not lead to any primary disease
of the lungs. This begins in the bronchial and the mediastinal lymph
glands, into which the lymph from the lung tissue passes. That
there may have been in such cases very insignificant disease of the
lung tissue itself is conceded, but it certainly eludes a very careful

93

search with the naked eye. In every case which came under the
writer’s notice, the lungs were thoroughly inspected and manipulated
with the hands, then the air tubes slit open and the manipulation and
inspection repeated. The primary affection of the lymph glands is in
some cases made more evident by the advanced stage of the tubercu-
lous process in the latter,;with no accompanying disease of the lungs
themselves.

Before giving any illustrations of this form of primary tuberculosis,
a brief description of the system of thoracic glands attacked will not
be out of place here, especially as they are not fully or even accurately
described ‘n the somewhat meager anatomical literature of this subject.
While, for example, some writers on tuberculosis tacitly assume that the
posterior mediastinal glands belong to the lungs, writers on anatomy
consider them independent of the lungs, and only refer to the bronchial
glands as strictly lung glands. The writer regards the posterior medi-
astinal glands as strictly pulmonary glands. This would be deducible
from their relation to tuberculosis of the bronchial glands and of the
lungs themselves. But there is a more cogent reason than this. A
careful comparative examination of the bronchial and the posterior
mediastinal glands will show that the pigmentation so characteristic of
the bronchial glands with advancing age is identical in quality and
quantity in the two sets of glands. In old cows the posterior medias-
tinals are as densely pigmented as the bronchials. Moreover, the gen-
eral appearance of the glands of the two sets is the same, and not to be
confounded with glands from other regions of the body.*

The bronchial glands (Pl. 1) are situated on the trachea at or near
the root of the bronchi of the different lobes. They might with equal
reason be denominated tracheal glands. Of these three are regularly
present.

The largest gland, the one most frequently involved in tuberculosis,
and hence of most importance to us, is situated against the trachea in
the angle formed by the left main bronchus with it (Pl. m1, A). It is
from 1 to 1.5 inches in diameter and of an irregular outline. It is firmly
attached to these tubes and rests on the left pulmonary artery. The
aorta arches over and conceals it.

The next largest bronchial gland is situated at the root of the right
Supernumerary bronchus on its ventral aspect and is firmly attached
to the air tube (PI. 111, C).

The third quite small gland (right tracheal) is situated against the
right side of the trachea near the bifurcation (Pl. 111, B). It is rarely
more than one-half inch in diameter. It is found in the incision between
the right ventral and the right caudal lobe, entirely concealed by sur-

* Each lymph gland or group of associated glands in the bovine body has a gen-
eral facies of its own, and a little well-directed observation will soon enable the
pathologist to tell the region whence came the gland, as the anatomist recognizes
bones and pieces of bones from a skeleton familiar to him.

94

rounding lung tissue. A fourth small gland is encountered in some
animals in the acute angle formed by the bifurcation of the trachea
(Pine):

It seems probable that the gland first described, and denominated
in these pages as the left bronchial, receives the lymphatics ramifying
about the bronchi (the peribronchial lymphatics). It is not improbable
that it receives the lymphatics of the right as well as of the left bron-
chus. Its situation allows this, and its large size, compared with that
of the right tracheal and its frequent infection, support this view.

Within the parenchyma of the left caudal lobe I have encountered
in rare cases diseased glands situated along the main bronchus,
between it and the pulmonary artery. They may be found in the
healthy lung, but only after careful dissection and search, as they are
very small. They do not seem to play any important role in tubereu-
losis, for they rarely obtrude themselves on account of enlargement.
They may be called intrapulmonary glands.

The posterior mediastinal glands (Pl. 1v) form a series or chain of
glands situated in the dorsal or posterior mediastinum between the
posterior aorta dorsally and the cesophagus ventrally. This chain
extends from the pillars of the diaphragm as far as the right super-
numerary bronchus. Some of the glands of this group may be felt in
situ after one sidé of the thorax has been removed, but they are best
studied by removing the lungs and heart with posterior aorta and
placing the mass with the dorsal aspect of the lungs uppermost.
After the aorta has been cut away and retlected these glands come
into view embedded in more or less fat, the lower ones resting on the
esophagus and pillars of the diaphragm and loosely held in position
by means of connective tissue and the serous membranes inclosing the
mediastinal space. ‘The number of glands in this chain visible to the
naked eye varies more or less in different animals. The hyperplasia
or enlargement following tubercular infection or inflammation of the
lungs may perhaps bring some into view and thus account for the var-
iable number.

The most important and most constant gland in this group is the
extreme caudal member of the chain near the tip of the caudal lobes
(Pl. Iv, a). Itis the largest gland of the chain. In the normal state
it is a flattened elongated body, from 4 to 6 inches long, three-fourths
inch broad, and one-half inch thick, rather firmly attached to the mus-
cular pillars of the diaphragm (g), and extending some distance back
(caudal) of the large ligament of the lungs (7). Its cephalic end is
usually divided, the left lobe projecting farther toward the head than
the right. Itis highly probable that this gland consists of two glands
fused together.

From this gland as a starting point the remaining glands seem to
range themselves in two incomplete series on the right and left side of
the mediastinal space. One series terminates in the left bronchial
gland, the other extends farther toward the head to the gland of the

95

supernumerary bronchus. The twochains may consist of three or four
glands only, or there may be as many as seven.

The difference between the bronchial and posterior mediastinal glands
in their relation to the lungs is this, that the former are firmly and
snugly attached to the air tubes, while the latter rest upon the cesopha-
eus, and are loosely connected with the lungs through the mediastinal
portion of the pleura. Both, as stated above, are identical in appear-
ance and in quantity and nature of pigment. It is probable that the
mediastinal glands receive lymph vessels which ramify beneath the
pleura (the subpleural lymphatics and their accessories), while the
bronchial glands drain the immediate vicinity of the air tubes through
the deep or peribronchial lymphatics.

If we turn to the literature of this subject we shall find that the
views just expressed are quite different from those in current works on
anatomy. As regards the functions of the posterior mediastinal glands
the following statement may be quoted:

Die hinteren Mittelfelldriisen haben ihre Lage an der Herzbasis unter der hin-
teren Aorta und am Schlund. Zwerchfell-, Mittelfell-, Schlund- und Herzbeutel-
lymphdriisen entleeren'sich in sie, ihre Verbindungen mit den Bronchialdriisen ermég-
lichen den Abfluss.

Die oberfliichlichen Loncenliympinee taser bilden unter der Pulmonalpleura ein
Netzwerk, das in die vorderen Mittelfell- und Bronchialdriisen seinen Abfluss nimmt,
in diese der Bifurcation der Trachea eingeftigten Gland. bronchiales, Lungendriisen,
ergiessen sich auch die tiefen den Bronchialverzweigungen folgenden Lymphgefisse
des Organes. (Article: Lymphgefissystem (Sussdorf), Koch’s Encyklopiidie der
gesammt. Thierheilkunde. )

According to this definition, the posterior mediastinal glands receive
the lymphatics of the diaphragm, mediastinum, cesophagus, and peri-
cardium only. If this were true the particles of pigment and the
tubercle bacilli would have to escape from the lungs into the thoracic
cavity first before they could come within the reach of the posterior
mediastinal glands. Furthermore, this definition assumes that all
lymphatics of the lungs empty into the bronchial and anterior medias-
tinal glands. The relation of the latter to the lungs is highly doubtful,
if by anterior mediastinals are meant the small group of glands within
the thorax under the first rib. These glands are not pigmented. They
receive the lymph from the chain of lymph glands of the head and
neck, and tuberculous changes in them are traceable in most cases to
tuberculosis of the neck glands. It is not to be denied—it is, on the
whole, highly probable—that the posterior mediastinal glands may
drain the territories mentioned in the definition, but that they also
stand in direct relation to the pulmonary lymphatics seems to the writer
unquestioned.

A uniform nomenclature of these two sets of glands does not exist.
While the terms “ bronchial glands,” ‘“‘posterior mediastinal glands,”
are in general use, R. Schmaltz* is inclined to donb the poe

“Topographische Anatomie der anpernolion Ace Ride ierencne I, 8. 20, 21.

96

mediastinal with his @sophageal glands. The bronchial glands are
separated by him into those which are attached to the trachea outside
of the parenchyma of the lungs (glandule lymphatice cardiales s. tra-
cheales postice) and those accompanying the bronchi into the lung
tissue (gl. lymph. bronchiales).

In view of the confusion existing both as regards the name and the
functions of the thoracic glands, a thorough reinvestigation of this
subject, by reason of its important bearing on tuberculosis, is highly
desirable. In the present article the writer maintains the position
that not only the bronchial but also the posterior mediastinal glands
as herein described are pulmonary glands, and that the anterior
mediastinal glands at the root of the thorax are not connected with
the lungs. A nomenclature of the functions would also be of far more
service than one of position or location.

It has already been stated that tuberculous changes in the lung
tissue are in almost every case accompanied by infection of the pul-
monary glands, as might be anticipated from the functions of these
glands. On the other hand, there are many cases of tuberculosis
limited exclusively to the pulmonary glands. Combining these two
groups of cases, it becomes evident that in almost every case of pul-
monary infection the pulmonary glands are attacked. Anexamination
of the tables on pages 159 to 144 shows this very clearly.

If we restrict our attention to the exclusively glandular tuberculosis
some interesting facts are at hand. In the 53 cases of tuberculosis
from one herd, 47 had been infected through the lungs. Of these, 27
had gland disease only, the lungs being free. A still closer analysis
shows that in 5 cases the mediastinals alone, in 5 the bronchials alone,
were diseased.

Among the bronchial set the left bronchial is most frequently
involved. Among the mediastinals the large caudal gland is the
favored’seat of tubercles. This gland, on the whole, is perhaps more
often found diseased than any other thoracic gland, and hence any
other lymph gland in body. It should never be overlooked in search-
ing for the primary seat of disease. In the 53 cases of the herd
referred to, this gland was diseased in 34. The left bronchial was dis-
eased In 24 cases only. The other glands of either group are not
infrequently affected at the same time, but there is no regularity in
this respect. In advanced cases all thoracie glands are diseased. In
other herds a similar restriction has been observed by the writer, pro-
vided the disease was not too far advanced.

In 9 cases from one herd, 3 had tuberclulosis of thoracic glands only.

In 17 eases from another herd 3 had tuberculosis of glands only.

In 8 cases from a third herd, nearly all of which were advanced
cases, 1 had gland disease only.

Finally, in 34 cases from a fourth herd 11 had the thoracic ‘disease
restricted to the glands, but of these 10 had tuberculosis of other organs
not in the thorax,

97

In order to get some information from carefully performed autopsies
recorded by other observers, I looked over the brief protocols published
recently by Réckl,* Schiitz, and Lydtin.t These observers examined
quite a number of animals, many of which had been recognized as
tuberculous before the application of the tuberculin test. These do not
concern us here, since they represent more or less advanced tuber-
culosis of the lungs. One series of 12 fattened cows from the same
herd is of interest, since they correspond closely to the animals described
in this bulletin.

Of these 12, one may be thrown out as doubtful, since some glands
were not examined. Of the remaining 11, one was free from tubercu-
losis, the rest infected.

The 10 cases may be tabulated as follows:

Mesen- | Portal |

Bron- | Medias-

el
Ss
|
im

| No. | chial tinal |Lungs.| terie :
| | glands. | glands. | glands. | glands. |
| i | + = i
Le or ap i — a = |
leetoead Sis + == = = = \
Voth ey he pas
fi Th i a ce ae m1

6 = | | + i = oa

7 — — +

8 oo ale ar om =

9 is re a

10 t — —

From this table it will be seen that in 4 the thoracic glands only
were affected. Five had pulmonary tuberculosis, and of these all but
1 had disease of the related glands. Infection by way of the lungs
is indicated in 90 per cent of the cases.

In another series of 19 animals from the same dairy and in good con-
dition 12 were found infected; 4 had gland tuberculosis only, the
remainder pulmonary as well as gland tuberculosis.

Siedamgrotzki and Johnet report upon a miscellaneous lot of 40
animals, of which 25 were found tuberculous. Of these only 2 had the
disease restricted to the thoracic glands. In most other cases the lungs
and thoracic glands were diseased. In a few no mention is made of
the thoracic glands. This may be due to an oversight.

Fischoéder, § in an analysis of 600 cases of tuberculosis observed at one
of the German abattoirs, states that 599 had tuberculosis of the thoracic
organs (infection through the air). In 210 of these, ?.¢. in more than one-
third of the total number, only the pulmonary glands were involved.

* Arbeiten aus dem Kaiserl. Gesundheitsamte, vul (1892), p. 1.

t Loe. cit., p. 48.

{ Deutsche Zeitschrift fiir Thiermedicin, xvi (1891), p. 66.

§ Zeitschritt f. Fleisch- u. Milchhygiene, 1v (1894), p. 8.
2891—No, 7——7

98

This preponderance of gland.over pulmonary disease in the earliest
stages of tuberculosis has not been pointed out with any emphasis
as an important regularly occurring phenomenon. When the writer
several years ago began his observations on tuberculosis for the
purpose of studying the modes of infection, the disease of the tho
racic glands was noticed by writers as something casual and acci-
dental, to be classed with the numerous other freaks of tuberculosis:
The necessity to tind some even slight lesion to account for the
tuberculin reaction has led recently to more careful examination of the
cadaver and a better knowledge of the disease itself.

In summarizing the relation of the thoracic glands to tuberculosis
we may safely lay down the general statement that in incipient or sta-
tionary disease the bronchial and posterior mediastinal glands play a
more important rdle than any other set of glands in the body. The
importance of a careful examination of them, especially of the most
‘audal mediastinal and the left bronchial gland, in determining the
presence of tuberculosis is, therefore, self-evident.

The primary infection of the pulmonary glands and of other glands
of the body is not accepted by all pathologists. Some claim that there
must be lesions at the point of entry, in the lungs, for example, which
are not recognizable, owing to their minute size. This subject will be
more fully discussed farther on. Meanwhile the primary infection of
lymph glands is accepted in this article as frequently occurring and in
fact as a characteristic of bovine tuberculosis.

The penetration of tubercle bacilli into and through the lung tissue
and their final lodgment in the lymph glands is probably due to the
nature of the bacilli themselves. They are in a thoroughly dry condi-
tion before they can be inhaled. Vassing through the trachea and
into the bronchial tubes with the current of air, they are deposited,
seized by some cell and carried into and along the lymph channels
into some puimonary gland in the same way as the pigment is carried.
Why they do not multiply at the place of deposit is probably due to
the inert state of the dried bacilli. Before they have assumed the
vegetative state, they have been carried as harmless foreign bodies
into the lymph glands, sharing thus the same fate as the inert particles
of pigment. They manifestly are unable to call forth any chemotactic
activity on the part of the body cells or to produce any so-called local
irritation until they have begun to multiply. The dried state and the
proverbially slow growth of tubercle bacilli subsequently may thus
account for the penetration of tubercle bacilli far into the body before
they begin to cause tuberculosis. In other regions of the body, such as
the intestines, the tubercle bacilli can not be considered as dried, and
here the simple inert character of the organism may account for its
being carried into the mesenteric glands without producing recogniz-
able lesions of the mucous membrane.

The infection of the pulmonary glands in the early stages of tuber-

99

culosis is in many respects a safeguard both to the affected animal and |
the rest of the herd. Tuberculosis of the lungs proper not only appears
to be more destructive, but, by virtue of the situation of the focus of
disease, a discharge of tubercle bacilli will take place sooner or later
which may endanger other portions of the lungs or the throat, and
which is always responsible for extensive secondary infection and great
enlargement of the lymph glands, especially the mediastinal. The foci,
primarily formed in the lymph glands, spread but slowly, and in many
instanees all tendency toward the dissemination of the lesions appears
to be checked. :

A question of much practical consequence presents itself here in
regard to the effect of repeated infection. That cattle may be infected —
more than once is self-evident when we consider the chances for such
infection. The writer has seen a few cases in which two independent
infections of the large mediastinal gland could be assumed from the
appearance and location of the disease foci. Again, the occurrence of
a number of independent foci in the lungs is frequently observed. It
might be supposed that the occurrence of disease of self-limited extent
following infection might favorably influence the organism by a kind of
jmmunizing or vaccinating process to resist equally well subsequent
infection. This view must be regarded as true within certain limits,
but the particular place where the second infection became located
would to a certain extent modify the result. Thus, two infections of
the thoracic lymph glands are less harmful than when the second infee-
tion lodges in the lung tissue itself, for this organ is more vulnerable
and the bacilli more likely to become diffused. When, therefore, the
lymph glands have become more or less impaired by disease the powers
of absorption become less active, and future infections are likely to
lodge in the lung tissue itself, because the bacilli may not be carried off
with that promptness which characterized the working of the normal
uninjured lymphatic system.

The practical application of these tacts is obvious. The more fre-
quent the infections the more rapid the disease and the speedier the
danger of the one case to other animals. The fewer the tubercle
bacilli in the air the more reduced the danger. It is highly probable
that cattle may under conditions inhale a few tubercle bacilli without
permanent injury. They may become absorbed into the lymph glands
and there the disease focus remain small and finally heal. The writer
has seen the large caudal gland of the posterior mediastinum exten-
Sively 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 uninterruptedly. The
importance of reducing the amount of infection in a herd by all possi-
ble means and keeping it permanently reduced is one necessary condi-

100

tion requisite for the successful eradication of tuberculosis. Even if
tuberculin does not reach every mild case, the perculiar nature of the
affection in virtue of which a slight amount of infection may be over-
come bridges over the gap which may have been left by turberculin.

The important facts bearing on tuberculosis of the lungs in cattle
are briefly as follows:

(1) Primary infection through the air is more frequent under exist-
jng conditions than any other mode of infection.

(2) The early stages of the disease may consist of glandular affec-
tions only.

(3) The extent and rapidity of the disease depend at least in part
upon the number of tubercle bacilli inhaled either within short or long
periods of time.

(4) Tuberculosis of the lungs is not necessarily associated with any
other recognizable lung affection as a preéxisting, favoring condition.

PRIMARY TUBERCULOSIS OF THE LYMPH GLANDS OF THE HEAD AND
NECK.

(Plates v and V1.)

These glands are so frequently the seat of primary infection that
they demand careful consideration. Before discussing their relation to
the disease in detail we will review briefly their location and function.
These glands are in pairs and symmetrically situated on both sides of
the body. They comprise the submaxillary, the parotid, the retro-
pharyngeal, and the postmaxillary glands.

Each submaxillary lymph gland or group of glands (PI. vt, C) is sit-
uated on the inner aspect of the lower jaw, in front of the angle. The
larger gland is hidden within the large anterior head of the submax-
illary salivary gland (/) and covered with some fat. After the skin is
removed a drawing away of the salivary gland from the boue exposes
at once the gland, which has the usual flattish shape and is about 1.5
inches long. The other glands, if present, are situated nearer the
angle. It receives the external lymphatics of the nose, lips, and cheeks,
and the lymphatics of a portion of the mucous membrane of the nose
and cheeks, and of the anterior portion of the tongue. It drains into
the retropharyngeal gland.*

The parotid gland (Pl. v1, A) is situated quite superficially. If a
line be drawn from the external meatus of the ear to the lower border
of the orbit of the eye the upper end of the gland touches this line and
is located about 1 inch in front of the meatus. The gland is about 1.5
to 2 inches lovpg and is partially concealed by the anterior margin of
the parotid salivary gland. This gland receives lymphatics from the
ear, the parotid salivary gland, the temporal region, and the pharynx.

* The information here given concerning the respective territories drained by these
glands is taken from Koch’s Encyclopedia.

101

The most important pairof glands, so far as tuberculosis is concerned,
are the retropharyngeal glands (Gl. tracheales s. cervicales superiores).
These are somewhat larger than those just described. Their situation
is most readily understood by examining Plate V, which represents the
head of a Jersey cow sawn through in the median plane. The indi-
viduals of this pair of glands are in close proximity to each other and
situated directly under the mucous membrane, covering the dorsal or
posterior wall of the naso-pharynx (the passage leading from the nasal
cavities into the esophagus). Each rests laterally on the hyoid bone.
Besides receiving the efferent vessels of the two sets of glands
described they receive the lymphatics of the caudal region of the nasal
cavities, including those of the pharynx.

In close proximity to these glands are another set which do not
appear to figure in text-books; at least the writer has been unable to
identify them with descriptions given. They are situated under the cau-
dal or posterior margin of that portion of the submaxillary salivary gland
which extends along the caudal margin of the parotid gland upwards
towards the ear. The glandular mass is irregular and usually sepa-
rable into two or three independent glands. They are denominated
here postmaxillary (Pl. v1, B).

The tonsils are situated under the mucous membrane of the posterior
region of the nasal passage. The opening is shown below the soft
palate as a black spot in Plate v.

One or the other of the four pairs of glands described and the ton-
sils represent the seat of primary infection inmanycases. An examina-
tion of the synoptic tables on pages 139 to 144 shows that the entire dis-
ease is not unfrequently limited to these glands.*

Of the four pairs, the retropharyngeal are by far the most frequently
diseased. This is due primarily to the important position of this pair,
and secondarily to the fact that it receives the lymph from the other
pairs, excepting, perhaps the postmaxillary, into which it may drain.
Hence it is incommon to find any of the other glands affected without
tuberculosis of these glands. On the other hand, they are diseased in
many cases when none of the others are involved. Although both
glands are usually diseased, it is not uncommon to find but one involved.
In the tables referred to above one cross indicates disease of but one
gland, two crosses of both glands.

The submaxillary glands are rarely diseased, hence any palpation
or inspection of the intermaxillary space for enlarged glands is likely
to prove fruitless in most eases. The parotid glands are also rarely
infected primarily. A swelling or tumor in front of one or both ears is
strongly suggestive of tuberculosis of these glands. Lastly, the post-
maxillary glands are also infrequently diseased. Any enlargement
causes a Oe he ° to appear behind the lower jaw.

*Whether the postmaxillary elands may be mare iheconeds or W eines they
receive the infection from the retropharyngeal glands remains to be determined.

102

The tonsils are less frequently diseased than one might suppose from
their situation. The largest percentage of tonsilar disease was found
in herd V (Table IV, p. 143). In one animal it appears to have been
secondary to tuberculosis of one of the retropharyngeal glands. A
small fistulous opening from the enormously enlarged gland was found
in the roof of the posterior nasal passage. The tonsil of the same side
appeared to have been only recently infected.

In tracing the channels of infection it is of considerable importance
to determine how far tuberculosis of the retropharyngeal glands may
be due to tubercle bacilli inhaled, or to such as are ingested with the
food. Writers are in general agreed that disease of these glands is the
result of food infection. It is not improbable that bacilli inspired in
the air are frequently deposited in the nasal passages with the dust.
Whether such bacilli are absorbed from the surface of the normal
mucous membrane is questionable. In the mouth, on the other hand,
the opportunities for slight laceration of the mucosa are more numerous,
and hence the chances for infection of the lymph glands better. More-
over, the tonsils may be active in the absorption of particles through
the agency of migrating leucocytes. If this be so it is strange that so
little tuberculosis of the tonsils is found with so much infection of the
retropharyngeal glands. Perhaps here, as in the lungs, the absorption
and passage through the tonsils into the lymph glands goes on very
rapidly, so that opportunity for multiplication is not given until the
bacilli have reached the lymph glands.

Besides the chances for direct infection from without these head glands
may also be secondarily infected with tubercle bacilli, which are coughed
up from the lungs when the disease in the latter organs is far advanced
and the broken-down tissue is discharging into some air tube.

If, as seems very probable, infection of the glands of the head is
to be ascribed largely to those tubercle bacilli which are taken into the
mouth with the food, the source of the bacilli may be looked for in the
milk or in the tuberculous discharges from nose and vagina, which eat-
tle may take into their mouth when they lick one another. The food
may also be infected with these discharges.

Tuberculosis of these glands always forms a prominent feature of the
bovine disease. In Herd I (Table I, p. 139) the retropharyngeal glands
were diseased in 9 out of 60 animals. In 5 of these no other focus of
disease could be found. Of the remaining four cases two were proba-
bly secondarily infected with tubercle bacilli discharged from softened
foci in the lungs. In Herd II (Table IL) the percentage of cases with
tuberculosis of the glands of the head is very high. An analysis of
the lesions found in the lungs indicates that perhaps a few may have
been infected secondarily from bacilli discharged from ruptured foci in
the lungs. Again in Herd V (Table IV) the infection of the lymph
glands of the head stands out prominently.

Tuberculosis of the retropharyngeal glands may become serious by

103

impeding respiration and deglutition. An examination of Plate V will
show that any enlargement of these glands will diminish the size of
the pharynx. When they become very large and are associated with
enlarged, diseased tonsils, the difficulty in breathing may become very
great by the encroachment of the passage from two directions. Case
H, page 143, is a good illustration of this condition. Though the ani-
mal breathed with difficulty and was emaciated, the only serious tuber-
culous lesions existed in the throat glands and the tonsils. Those in the
chest were trifling. In cow No. 292 (Table V) one of the retropharyn-
geals measured 5 by 4 by 3 inches, the dimensions of the normal gland
of the opposite side being 14 by 1 by 4 inch, or only one one hundred and
sixtieth of the volume of the tuberculous gland. A minute opening from
this gland through the mucosaof the roof of the nasal passage was found,
through which putrefactive bacteria had entered. and the disintegrated
tuberculous tissue was discharging outward. The enormous gland had
greatly encroached on the space of the pharynx and the epiglottis was
displaced so as to appear obliquely placed. A serious result of this con-
dition was the presence of small pneumonic foci in the lungs, due to the
aspiration of foreign particles. Theimpaired swallowing permitted such
particles to enter the trachea. In the minute plugged air tubes of the
affected lobules, vegetable fibers were found completely encrusted with
leucocytes. Only traces of tuberculosis were found in the lungs and
one gland in the mesentery was affected. The visible signs of disease
in this animal may thus be attributed exclusively to the enormous
throat gland.

The comparative frequency of tuberculosis of the glands of the head
in the herds examined by the writer does not appear to be paralleled
in other countries. The latest most extensive figures of Fischéder
include only 6 cases of tuberculous “cervical glands” out of 600, or but
1 per cent. This small percentage it is hard to account for.

PRIMARY TUBERCULOSIS OF THE MESENTERIC GLANDS, THE INTES-
TINES, AND THE LIVER.

The glands within the layers of the mesentery are very frequently
the seat of tuberculous lesions. A glance at the tables is sufficient to
show this. In nearly all cases the evidence is pretty positive that the
tubercle bacilli were absorbed from the contents of the intestines and
not from the circulating blood. They must, therefore, have passed
through the stomachs with the food and resisted the destructive action
of the digestive process. When we come to analyze this mode of infee-
tion more minutely the source of the infectious material is not always
recognizable with certainty, Since disease of the mesenteric glands is
rarely seen by itself, other foci being in almost every case associated
with it. In the cases summarized in Tables I to V, only one animal is
shown to have exclusively disease of the mesenteric glands and of the

104

liver (No. 333 in Table I). In all the remaining cases there are tuber-
culous foci either in the lungs themselves or in pulmonary lymph
glands, which indicate infection through the inspired air as well. These
cases range themselves in two groups, those in which the lungs them-
selves are affected, and those in which only the pulmonary glands are
diseased. In the former group of cases the tubercle bacilli may have
been coughed up from the disintegrating foci in the lung tissue, swal-
lowed and absorbed from the intestines into the mesenteric glands. In
the latter group this could not occur because the tubercle bacilli are
locked up inthe lymph glands of the thorax. In this group, therefore,
the infection of the digestive tract must be regarded as independent of
the lung infection.*

A careful examination of the autopsy notes of herd I (pp. 31 to 59) will
show that even in many cases of pulmonary disease, either the lesions
are not far enough advanced to account for the disease of the mesen-
teric glands, or else the stage of disease in the latter is as old as, or
perhaps older, than the lung disease. Hence we may safely affirm
that in many cases of tuberculosis the animals have both inhaled and
ingested the tubercle bacilli, thus starting at the same or at different
times, two independent foci of disease.

Tuberculosis of the mucous membrane of the intestines is very rare.
The writer very carefully examined the digestive tract of the animals
included in Table I without finding tuberculous changes in the mucous
membrane, with the exception of one advanced case (No. 538), in which
there was evidently an abundant discharge of tubercle bacilli from the
lungs. In this case, which was near the point of death, all: Peyer's
patches of the small intestine were extensively infiltrated with tuber-
cles. (See p. 124 for worm tubercles vs. genuine tubercles).

In the animals included in the other tables, no systematic examina-
tion of the intestines was made, i. e., the tube was slit up throughout
its extent in only a few cases, but the serous surface was more or less
carefully inspected to note any signs of disease in Peyer’s patches.

The presence of tubercle bacilli in the liver may manifest itself by tuber-
culousfoci in the liver tissue, or what ismore common, by tuberculosis of
the lymph glands situated in the portal fissure, and denominated portai
glands in the tables. An inspection of these will show, out of 123 tab-
ulated cases, 29 with tuberculous portal glands. Of these, 12 have deposits
in the liver at the same time. Three have disease of the latter with-
out corresponding infection of the glands. Hence, in determining the
presence or absence of infection of the portal system the portal glands
must be carefully searched for tubercles.

Tuberculosis of the liver is probably, in most cases, a result of food
infection. This is made evident by the fact that in most cases of liver
tuberculosis the mesenteric glands are also diseased. In the 29 cases

* Nos. 346, 348, 355, 358 in Table I; Nos.599 in Table II; J in Table III.

105

tabulated all but 4 are associated with disease of the mesenteric glands.
Of these four one is associated with disease of throat glands, also
indicative of food infection. In the three cases remaining the disease
may be secondary to lung disease in one and primary ib two.

The sources of the bacilli which enter the portal system may be sev-
eral. The bacilli may be absorbed directly from the mucous membrane
of the intestines into the venous radicles of the portal system. They
may also pass from some focus in the mesenteric gland into the portal
system. In either case the original source is the contents of the
intestines. Primary infection of the liver during fetal life will be
discussed further on.

OTHER ORGANS WHICH MAY BE PRIMARILY DISEASED.

We have seen that the primary foci of infeetion are in the great
majority of cases situated (1) in the lungs or the bronchial and medias-
tinal glands, and (2) in the glands of the neck and head, the mesen-
teric glands, the portal glands, and in the substance of the liver. The
first indicate infection through the inspired air, the second through
the food. Of the other seats of primary disease only the udder and
the genital organs (the uterus) come into consideration. Bang* is
inclined to believe that tuberculosis of the udder does now and then
appear primarily in animals which are in very good condition. A case
recently examined is of interest in this connection.

A large Jersey cow, registered,6 years old, kept in a large herd under
very good sanitary conditions, has had some trouble with the right half
of the udder for two years. During this time only the anterior quarter
of this side was milked. Atthe beginning of this year (1894) she gave
birth to a ealf, but “did not clean well.” She was killed in April,
although in very good condition at the time if we except the vaginal
discharge. The affected half of the udder was uniformly larger than
the secreting half and very firm. The autopsy showed the following
conditions: ;

The right half of the udder with the exception of a narrow anterior
segment was involved uniformly in tuberculosis The cut surface had
a mottled pink and pale yellowish appearance throughout. A few cir-
cumscribed areas were somewhat further advanced in caseation, for
they appeared more uniformly opaque, yellowish, the pinkish element
having disappeared. No old focus of disease could be found in the
udder from which a dissemination of the virus into the surroundings
could be inferred to have taken place. Cover-glass preparations made
by gently scraping the cut surface and rubbing the material so obtained
on slides showed many tubercle bacilli. Sections of the organ hard-
ened in alcohol were equally conclusive as to the nature of the affee-
tion. Every acinus was the seat of one or more tubercles. In some a

* Deutsche Zt-chr. f. Thiermed., x1 (1884), p. 45.

106

little of the secreting epithelium was still left; in others it had been
completely crowded out by the neoplasms. In only a small percentage
of the tubercles was the center necrosed. Tubercle bacilli were very
abundant, both in the numerous giant cells and in the peripheral zones
of each tubercle. The pubic lymph glands in this animal were very
much enlarged and contained minute, isolated, and confluent necrotic
foci. Tuberculosis was detected in other organs, as shown in the fol-
lowing post-mortem notes, dictated by the writer:

Both retropharyngeal glands contain small foci of tuberculosis of recent origin.
In both principal lobes of the lungs there are a considerable number of foci, involy-
ing each one or more lobules. Some are uniformly necrotic, but not softened; others
are composed of groups of isolated tubercles. In the smaller lobes a small numberof ~
similar foci exist. The large mediastinal gland is 4 by 2 by 5 inches in size. It con-
tains large yellowish, partly calcareous foci. Left bronchial gland, about 2 inches
in diameter, in the same condition.

A whitish pasty exudate in one horn of the uterus, the walls of which are nearly
half an inch thick and contain small caseous foci. Tuberculosis determined in see-
tions of hardened tissue.

This case is peculiarly interesting on account of the extensive tuber-
culous infiltration of the udder. Was it infected from without or through
the blood? The most reasonable explanation seems to be the latter.
The disease in the lungs, the uterus, and the udder was, according to
microscopic examination, in about the same stage. That of the medi-
astinal glands was in a more advanced stage. The probability is that,
during the violent disturbance occasioned by the birth of the calf, tuber-
cle bacilli were carried into the circulation from the older focus in the
mediastinal glands. They lodged and subsequently multiplied in the
organs mentioned. The uniform diffusion of the disease in the udder
might be explained by a rapid disintegration of some small foci and the
downward dissemination of the tubercle bacilli through the milk ducts.

Another hypothesis entertained by the writer was the infection of the
udder from without through the milk ducts. This would appear well
nigh impossible in an udder milked twice a day, by which process all
entering tubercle bacilli would be washed out promptly. Considering,
however, that in this animal the affected quarter had not given milk
for two years, we can not rely on the washing out of the ducts in this
instance. Another question naturally arises in this connection, whether
tubercle bacilli are capable of growing along a milk duct in competition
with other bacteria. We know that they are often present in enormous
numbers in necrotic tissue, but whether they may live in the secretions
of a mucous surface so as to become disseminated is open to serious
doubt when we bear in mind their peculiar parasitism.

Another mode of entrance would be through injuries of the udder
itself. If the injury were deep enough the bacilli might be deposited
directly in the gland tissue, but a mere abrasion is hardly a suitable
place of entry. In deep lacerations the tubercle bacilli would very prob-
ably have to compete with pyogenic bacteria introduced at the same
time.

107

The whole subject of udder tuberculosis needs more careful study,
especially with reference to the question of primary infection. This
question is of great importance because a primary infection would be
all the more dangerous since it might be associated with an otherwise
healthy organism and thus ward off suspicion until much damage has
been done by the milk.

Primary infection of the uterus from without could hardly take place
excepting during copulation. The bull may carry tubercle bacilli from
one cow to another without necessarily being diseased himself, as in the
cease of tuberculosis of the uterus associated with vaginal discharge.
In ease the genital organs of the bull are affected the transmission of
tuberculosis to the cow is easily understood. Nevertheless, primary
tuberculosis of the uterus does not appear to be very common. In
most cases with diseases of this organ, the infection may be traced to some
other preéxisting focus in the same animal. Local infection of the bull
from the cow seems to be comparatively rare in spite of the fact that
tuberculous lesions of the uterus associated with the discharge of
tubercle bacilli in catarrhal secretions are notinfrequent. Even tuber-
culosis of the vagina and vulva have been reported.*

An interesting case of probable infection through the genital organs
is No. 634, in Table II. A buli calf about 8 months old, which had
given a reaction after the injection of tuberculin, was killed and ecare-
fully examined. Only one focus of disease was found. The pubic
glands were enlarged and studded with yellowish tubercles. Since
there was no other primary focus in the body, no indication of general-
ized infection, the only explanation left was the contraction of the dis-
ease from some cow with tuberculous uterus. The bacilli were absorbed
from the external genital organs and deposited in the corresponding
lymph glands.

A case of primary tuberculosis of the penis in a bull was reported by
A. Ebert several years ago.

THE RELATION OF THE LYMPHATIC SYSTEM TO THE PRIMARY SEAT
OF TUBERCULOSIS IN CATTLE.

In the preceding chapter it was pointed out that a large proportion
of the cases in which tuberculosis was either in an incipient stage, or
else restricted to a single focus, the lesions were found in the lym- .
phatic glands, which drain certain organs exposed to infection and not
in these organs themselves, and it has been tacitly assumed that the
tuberele bacilli passed through these organs into the respective lymph
glands without leaving any trace of disease behind.

Thus in infection by way of the lungs the tubercle bacilli pass
through the tissues of the parenchyma, and are carried in the lymph

~ Deutsche Zeitschrift f. Thiermedicin, xvii (1891), p. 195,
t Loe. cit., p. 188. ;

108

channels to the corresponding lymph glands. In infection by way of
the intestines, the tubercle bacilli pass through the mucous membrane
into the mesenteric glands, or by way of the portal system, into the
liver. The same may be said of the mouth and nose. The bacilli
deposited on the mucous membrane are carried into the lymph glands
without causing any visible lesion of the mucous membrane. These
conditions hold for only a portion of the cases which come under
observation, for in the remainder the parenchyma of the organs is
involved in the disease. In some of these cases, however, there still
remains the question whether the earliest lesions may not have been
limited to the lymph glands.

That tubercle bacilli may pass into the lymph channels of organs
without leaving in the latter any trace of disease was first distinctly
pointed out by Weigert* with regard to tuberculosis in children. He
called attention to the fact that tubercle bacilli may enter the mouth,
the iungs, and the intestines, and affect the respective lymph glands
without first causing disease of these organs. In case of the lungs,
secondary infection may take place later on from the lymph glands by
contiguity. He furthermore pointed out that scrofula in children is
explained by the absorption of tubercle baciili from the mouth and
their retention and multiplication in the glands of the neck. In adults
the reverse is usually true. The parenchyma of the organs becomes
affected first, and the lymph glands afterwards.

Bollingert likewise admits the absorption of tubercle bacilli without
the appearance of a local lesion.

Veterinary pathologists have also called attention to this peculiar
behavior of tubercle bacilli. Hartensteint speaks of the lymph glands
as excellent reagents for the presence of tubercle bacilli in the body
Eber-Johne§ and Rieck || also refer to the restricted localization of
tubercle bacilli in the lymph glands. Baumgarten, ] on the other hand,
maintains the position that tubercle bacilli can not pass any organ or
mucous membrane without causing tuberculous lesions at the place of
entry.

Tangl,** working on this theme at his suggestion, comes to the same
conclusion. The latter found that in guinea pigs the application of
tuberele bacilli to the uninjured conjunctiva produced at first local and
subsequently generalized tuberculosis. In rabbits, on the other hand,
neither local nor subsequently general tuberculosis was produced. The

* Jahrbuch fiir Kinderheilkunde, xx1r (1884).

+t Tenth International Congress at Berlin, 1890.

t Archiv f. wiss u. prakt. Thierheilkunde xvi (1890), S. 354.

\ Encyklopiidie d. gesammt. Thierheilkunde (Article Tuberculosis).

||Archiy f. wiss. u. prakt. Thierheilkunde, x1x (1893), S. 1.

Pathologische Mykologie. Arbeiten a. d. path-anatom. Institut zu Tiibingen. I.
Ueber experimentelle congenitale Tuberkulose.

**Centrablatt fiir allgemeine Pathologie, 1 (1890), S. 763.

109

experimental observations of Dobroklonski* do not appear to give much
support to Baumgarten’s view. He fed guinea pigs with a few drops
of pure cultures of tubercle bacilli and studied the mucous membrane
of the intestines at different intervals. He found that, although the
epithelium remained intact, the solitary and agminated follicles, or
Peyer’s patches, soon began to show signs of disease. The tuberculous
changes might also. though very rarely, take place in the subepithelial
layer of the mucosa. The rapidity with which the bacilli penetrated
into the lymphatic system was demonstrated by the fact that tubercle
bacilli were found as early as the fourth day in the mesenteric glands,
and that the tubercles appeared as soon in these glands as in the lymph
follicles of the intestine.

Whichever view we may adopt, the fact remains, that ina very large
number of cases of bovine tuberculosis in the earlier stages a most
careful scrutiny reveals only disease of the lymph glands. If the bacilli
do cause disease of the lungs on thei way to the thoracic glands the
lesion remains invisible to the naked eye and heals up. The same may
be said of the intestines and mucous membrane of the mouth and nose.

DISSEMINATION OF TUBERCLE BACILLI WITHIN THE BODY FROM THE
PRIMARY FOCUS.

After the lodgment of tubercle bacilli in the primary focus, where
their multiplication stimulates the formation of the neoplasms or
tubereles peculiar to this malady, the disease may after a time become
stationary and the tuberculous products finally undergo calcification.
In most cases, however, the disease, after being purely local for a time,
and not disturbing the normal functions of the animal to any recogniz-
able degree, spreads from the original focus more or less rapidly and
invades the more organs and structures the longer the life of the affected
animal. ‘The courses which the virus takes in moving from the primary
focus or foci to establish new centers are subject to much puzzling vari-
ation and kave been the subject of much investigation and speculation.
The development of the meat-inspection service in Germany has stimu-
lated discussion in this field perhaps more than in any other connected
with bovine tuberculosis.j In general the tubercle bacilli may be dis-
seminated 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
membranes (pearly disease). Inasmuch as this is a very important
type of the disease we will discuss it by itself first.

* Archives de Médecine expérimentale, 11 (1890), p. 253.

tThose who would pursue this phase of the subject are referred to the writings
of Ostertag, Schmidt-Miihlheim, Hartenstein, and those of Carl Weigert for human
tuberculosis.

110
TUBERCULOSIS OF THE SEROUS MEMBRANES (PEARLY DISEASE).

This form of the disease, if such it may be justly called, has always
created more or less interest, largely owing to the very remarkable
growths produced on parts of the body at once exposed to view when the
carcass is opened. Formerly it was customary to consider tuberculosis
of the orgaus and tuberculosis of the serous membranes (pleura, peri-
cardium, peritoneum) as more or less distinct, although associated
forms, of disease. This view is gradually giving way as our knowledge
of the progress of the disease in the body is becoming more thorough.
Rieck,* with reference to this same subject, says that former statisties
which maintain that there is a large number of cases of tuberculosis of
the serous membranes exclusively must rest upon partial examination.
He himself states that in all of the many cases examined by him at the
Leipsic abattoir pearly disease was associated either with tuberculosis
of the bronchial, mediastinal, or mesenteric lymph glands.

So far as the writer’s observations have gone they fully confirm Rieck’s
statement that tuberculosis of the serous membranes is not primary.
In the 53 tuberculous animals of the herd in Table I tuberculosis of the
serous membrane was observed but three times. In one case (No. 338) it
was associated with widely disseminated and severe lesions of the lungs
and lymphatic apparatus. In the second case (No. 314) the costal
pleura was affected by contiguity from a large pulmonary focus, and in
the third case (No. 345) the abdominal diaphragm was studded with
tubercles which were secondary to disease of the thoracic glands.

In the cases presented in the other tables tuberculosis of the serous’
membranes is also associated with glandular tuberculosis.

The very small percentage of cases in which the serous membranes
were found diseased by the writer, and the absence of any primary
infection of these membranes, are facts significant in confirming Rieck’s
statement that tuberculosis of the serous membranes is quite a second-
ary phenomenon and does not deserve the attention which has been
accorded to it up tothe present. It is probably never present in ineipi-
ent cases or in such as have been healed or become stationary in the
earliest stages. If tuberculosis of the pleura or peritoneum is found
it should be regarded as an indication that further search be made,
especially in the thoracic and the mesenteric glands, for the seat of
primary infection.

In the many isolated cases of advanced tuberculosis examined dur-
ing the past five or six years by the writer tuberculosis of the serous
membranes was never absent. Sooner or later these membranes
become the seat of a more or less extensive tubercle eruption. This
may occur when the disease travels by contiguity, as from lung tissue
to pulmonary pleura, and thence to the costal pleura, to which the dis-
eased pulmonary pleura soon become adherent. Or it may be due toa

*Archiv f. wiss. u. prakt. Thierheilkunde, xrx (1893) S. 1.

111

backward flow of lymph, an occurrence contirmed, in the writer’s opinion,
by ease No. 343, p. 48. In this animal there were several tuberculous
foci in the lungs but no pleural tubereles. The posterior medias-
tinal and the bronchial glands were at least as large as fists (one
mediastinal 8 by 5 inches) and consisted mainly of sacs of partly
cheesy, partly puriform matter. The large caudal mediastinal gland
was least affected. Curiously enough the abdominal aspect of the
diaphragm was studded with a considerable number of flattish, rather
large, sessile, tuberculous masses. An adhesion between the dia-
phragm had led to the formation of a similar mass on the capsule ot
the liver. Between this and the diaphragm the adhesion had expanded
into a very delicate false ligament, on the free margin of which were
several tuberculous masses.

The infection of the peritoneal surface of the diaphragm must have
originated in this case from the lymphatic glands of the thorax, which
receive the lymphatics of the diaphragm. The capsule of the liver
was infected by contiguity for the parenchyma and the portal giands
were normal. The mesenteric glands likewise were free from disease,
hence the intestinal origin of the infection must be excluded. The
tubercle bacilli could not have traveled through the diaphragm from
the pleural side, for there was no disease of the pleura. There seems to
be no other explanation than that the tubercle bacilli were forced back
from the greatly enlarged, tuberculous, lymphatic glands of the posterior
mediastinum into the lymph channels, which have their roots in the
diaphragm. The possibility of such a retrograde movement of tuber-
cle bacilli or cells containing them is made evident when we bear in mind
the peculiar conditions. The bronchial and mediastinal glands were
very large, one alone as large as a child’s head. The filling upof much
of the available thoracic space by these glands must have led dtring
paroxysms of coughing to a considerable positive pressure within the
cavity of the thorax, by which lymph may have been forced back into
the peritoneal cavity. This mode of distribution of the tubercular
virus may perhaps be not so rare as would appear at first thought,
and it may be that a careful examination of a large number of animals
in which the disease is still more or less restricted to the thorax will
demonstrate occasional infection of the serous membranes in this way.

These observations, added to those of Rieck, go far toward proving
that what has been called pearly disease in cattle is nothing more than
a manifestation of a more or less advanced stage of tuberculosis of
certain organs, especially the lymph glands, from whence it has over-
flowed, as it were, through the lymphatic system. This condition may
be brought about, at least in part, by a marked resistance of certain
organs of the bovine organism to tuberculosis. The lymphatic system
offering least resistance becomes the seat of a chronic, prolonged dis-
ease process, in which the serous membranes, after a time, take part.
This marked localization of the process is well exemplified in No. 338.

112

Besides the lungs no other organ was attacked by visible tubereulous
changes. The disease was restricted to the lymphatic system, includ-
ing the large serous cavities and, lastly, Peyer’s patches of the small
intestine.

We may then summarize the ways in which tuberculosis of the serous
membranes takes place as follows: (1) By escape of bacilli from some
focus of disease situated under one of the serous coverings, such as
lungs, liver, intestines, and associated lymph glands. If many bacilli
enter a serous cavity an extensive eruption of tubercles is likely to
appear in the peritoneum, chiefly on the omentum; in the thorax,
mainly on the dependent portion of the lungs. (2) By an accidental
temporary reversion of the lymph current by which bacilli may be car-
ried backward from the diseased gland. (3) The disease may travel

from pleura to peritoneum and from peritoneum to pleura by a simple —

growth of the tubercles through the diaphragm (Weigert).

Tuberculosis of the serous membranes seems to cause least damage
to the animals affected, if we are to judge from occasional autopsies,
in which an enormous number of tubercles on these membranes may
be compatible with a very fair condition of the animal, provided organs
like lungs and liver are not seriously involved at the same time. There
is, of course, more or less encroachment of space and perhaps consider-
able impediment to the normal gliding of organs on neighboring strue-
tures. A case of this kind is found on Table II (No. 590). On opening
the abdominal and thoracic cavities an exceedingly extensive eruption
of tubercles was found on peritoneum, pleura, pericardium, and epicar-
dium. The impression conveyed by this appearance was of extensive
organic disease. This was not the case, however. In the head the
submaxillary and retropharyngeal glands were badly diseased, but in
the thorax the lungs were free, in spite of the pleural affection, and the
disease was restricted to the large mediastinal gland. Inthe abdomen
the peritoneal disease had invaded the uterus. The mesenteric and
lymphatic glands were affected and the serous covering of the liver
was studded with tubercles, but there was no disease of the parenchyma
of the liver, spleen, or kidneys. In this case the pearly disease may
have started from a tuberculous mesenteric gland.

It doesnot appear probable, from observations made at autopsies, that
organs are invaded to any extent by tuberculosis starting on their
serous covering. There is, however, one important exception. Tuber-
culosis of the Fallopian tubes and of the uterus appears to be largely
an extension of the disease by contiguity from the peritoneal covering
of these and adjacent organs.

DISSEMINATION OF TUBERCLE BACILLI IN THE LYMPH CHANNELS.

The spreading of tuberculous lesions from one gland to another in
the direction of the lymph stream is frequently observed. The progress,

113

however, seems to be so slow that this mode is frequently overtaken by
others and the animal succumbs before much progress is made.

Successive infection of the glands of the head and neck is now and
then noticed. In No. 611 (Table IT) all the glands of only one side of
the head (left parotid, submaxillary, retropharyngeal, and post maxil-
lary) were diseased, those of the other side healthy. In another case
not tabulated the infection could be traced from the glands of the head
to those at the root of the neck. In No. 292 (Table V) the right retro-
pharyngeal and post maxillary glands and the right tonsil were dis-
eased, the corresponding structures on the left side normal.

‘In tuberculosis of the mesenteric glands the bacilli may, as has been
stated, become diffused over the peritoneum or, what is more probable,
carried into the thoracic duct.

In tuberculosis of the liver the tubercle bacilli are usually carried
into the portal lymph glands at the hilus. They may also be carried
through the lymph channels, which are said to pass from the liver into
the thoracic cavity. Here they would probably be deposited in the
large caudal mediastinal gland. This mode of infection of the medias-
tinal gland is probably extremely rare. For in incipient cases the
mediastinal glands are in many cases diseased and the liver free. On
the other hand, the liver may be extensively diseased, but the mediasti-
nals free (No. 333, p. 43).

While tubercle bacilli appear to be usually carried in lymph chan-
nels with the current, one case of evidently retrograde movement of
the tubercle bacilli has been noticed and already referred to on page 111.

DISSEMINATION OF TUBERCLE BACILLI THROUGH THE BLOOD (GEN-
ERALIZED INFECTION).

The virus of tuberculosis does not vegetate in the blood. Its presence
in this fluid is accidental, due to the rupture of a caseous focus into some
blood vessel, or into lymph channels (right and left thoracic ducts) emp-
tying directly into the blood stream. The disease is therefore, as a rule,
pretty generally distributed by repeated primary infection, by the lym-
phatic system and by auto-infection before indications of blood infec-
tion are manifest. Even after tubercle bacilli have entered the circu-
lation they are speedily fixed in the parenchyma of tne various organs,
so that unless there is a continual discharge of tubercle bacilli into the
blood from some focus of disease the blood infection is very tempo-
rary.

Infection of the blood may occur repeatedly in the more advanced
stages of tuberculosis. Comparative pathologists have for convenience
adopted two designations for two somewhat different forms of the gen-
eralized disease. When the blood has been infected with only a small
number of tubercle bacilli, foci may be found scattered through the
body, but only in small numbers. This condition has been denomi-

2891—No. 7-——8

114

nated by Ostertag as chronic generalized tuberculosis. When a large
number of bacilli have escaped into the circulation and an eruption of
a large number of tubercles appears in various organs, such as kidneys,
spleen, and liver, the disease has been called acute, generalized tuber-
culosis. The chronic form with occasional tuberculous foci in the
parenchyma of organs or the glands associated. therewith is not uncom-
mon; the acute form, however, at least in that stage in which numer-
ous tubercles are visible-to the unaided eyes within the spleen, liver,
and kidneys, is quite rare. The chronic form is seen chiefly in old cows
which have struggled with tuberculosis for many years and in which,
during this long period, there has been perhaps one, perhaps more tem-
porary entries of tubercle bacilli into the circulation. It is now and
then seen in comparatively young animals.

The parenchyma of the liver, spleen, and kidneys appears to be more
or less opposed to the multiplication of tubercle bacilli, for even when
there has been blood infection at some time the tubercle bacilli may
leave these organs where they have been deposited by the blood stream
and pass by way of the lymph channels into the lymph glands belong-
ing to such organs, where the destructive process assumes proportions
soon visible to the unaided eye. Hence, in endeavoring to trace any
generalized infection, the lymph glands of such organs as the kidneys
should always be examined. it is this fact which led Hartenstein to
regard the lymph glands as the best (and often the only) reagents for
the presence of tuberculosis in cattle. That generalized infection may
have occurred without being recognizable to the unaided eye is proved
by case No. 233 reported in Bulletin No. 3, page 62. The milk of this
animal contained tubercle bacilli shortly before death. The udder was
free, but in the pubic glands a few small yellow tubercles were found.
In a fresh section of liver tissue giant cells were observed, aud when
subsequently sections of hardened tissue were examined numerous
beginning foci of disease were found, each consisting of one or two
giant cells embedded in a slight zone of round cells and containing
tubercle bacilli.

Generalized infection may thus be recognized by the discovery of
foci of disease in organs not accessible to the virus in any other way
than through the circulation, or in the lymph glands of such organs.
Tuberculosis of the subcutaneous lymph glands and of those situated
in the muscular tissue of the trunk and limbs is universally accepted
as indicative of the generalized disease. Such glands may be infected
from without, but infection through wounds of the skin is probably
quite rare.

The terms blood infection and generalized infection are not directly
synonymous and require further definition. When tubercle bacilli enter
the portal circulation from the digestive tract, they are carried into the
liver where they inay all be filtered out and fixed. Should they pass
into the hepatic circulation they may reach the right side of the heart

115

and thence be distributed through the lungs. In order that they may
gain the general or systemic circulation they must pass through the
capillaries of the lungs to reach the left side of the heart. Hence we
may have a local infection of the portal circulation, as well as of the
pulmonary circulation without infection of the blood going to the whole
body. When tubercle bacilli enter the thoracic duct from diseased
glands of the abdomen or thorax, they enter the venous system and
therefore they must first run the gauntlet of the capillary system of the
lungs before they may enter the general circulation. The condition
most favorable to infection of the entire body is tuberculosis of the
lungs with discharge of tubercle bacilli into any branch of the pulmonary
vein. They will then pass directly to the left side of the heart to be
distributed over the entire body. Should tuberculous foci break into
arteries the conditions would be somewhat different and their conse-
quences easily traced. Their denser coat probably prevents this acci-
dent from occurring.*

Generalized infection has been quite frequently observed at German
abattoirs. Referring to our own cases in Tables I, Il, and III, and
excluding those on Tables [IV and V as being mainly selected for their
suspicious or bad condition, we have among the first lot of 108 animals
3 cases of generalized infection.t Ifwetake those advanced cases given
in Tables IV and V, exclusive of D and No. 237, not known to be tuber-
culous when killed, we have out of 12 cases 4 with generalized disease.
This bears out the general assumption that, with rare exceptions,
generalized disease appears late in the course of the disease.

Generalized infection, both chronic and acute, has received consid-
erable attention, especially by German authorities, because of its
important bearing on the infectiousness of meat and milk. Infection
of the bony and muscular tissue, and more particularly the lymph
glands embedded in them, is regarded as of sufficient gravity by the
German meat-inspection authorities to forbid the utilization of the meat
of such animals, excepting after it has been cooked under the direction
of these authorities. Since tuberculosis of the bones and muscular
tissue, or of the glands embedded in them, is possible only after the
virus of tuberculosis has been transmitted in the blood, generalized
infection manifesting itself in any part of the body throws suspicion on
the meat.

*The immunity, as it were, of at least the larger arteries, owing to the denser
structure of their walis, is very well shown in contagious bovine pleuropneumonia.
In this disease the coats of the pulmonary veins embedded in the diseased region
are frequently penetrated by cell infiltration from the surrounding connective tissue.
This leads to inflammation of the intima and thrombosis. In the arteries, on the
other hand, thrombi are not found.

+The diagnosis in one of these cases (No. 303, page 32) is based on the presence of |
old tuberculous deposits in the udder (pubic) lymph glands. Inasmuch as the infec-
tion may have come from without through the udder (although this the writer is not
inclined to believe), blood infection in this case is somewhat doubtful,

116

Generalized infection is furthermore of great importance in its bear-
ing on the infection of milk. The possibility of udder infection from
without being conceded, we nevertheless find that most of the udder
tuberculosis encountered is a result of blood infection. The tubercle
bacilli are carried from some internal focus by way of the blood
into the udder. Hence, in all cases of generalized disease, the milk
should be regarded as dangerous. The difficulty from the practical
standpoint lies in the recognition of such generalized infection during
life. With the meat the question is simple enough and resolves itself
into the thorough inspection of every carcass at the abattoir by a
trained inspector. With the living animal we have only a few guides,
such as the condition of the udder (pubic) lymph glands or the
enlargement of some of the superficial lymph glands, such as those of
the shoulder and flank. But even these guides are untrustworthy and
liable to lead to erroneous inference at any time. This question of the
relation of tuberculosis to the public health is too broad a one to be
discussed here and it has been referred to simply to call attention to
the important practical bearing of blood infection in tuberculosis.

INFECTION OF ANIMALS BY THEIR OWN TUBERCULOUS DISCHARGES
(AUTO-INFECTION).

Cattle may become reinfected by their own tuberculous discharges
and thereby materially hasten the dissemination of the disease in their
own bodies. Perhaps the most common process of reinfection is the
swallowing of tubercle bacilli which have been coughed up from some
disintegrating focus in the lung tissue. Tubercle bacilli coughed up in
this way frequently produce more or less extensive tuberculosis of the
bronchial tubes, the trachea, and the larynx. It has already been stated
that tuberculous lesions of these structures have not been observed
excepting where the lung tissue itselfis involved and the disintegrated
tissue is breaking into an air tube. The inference that infection of the
air tubes is secondary to the lung lesion, is, therefore, justifiable. The
tubercle bacilli coughed up may further infect the tonsils and lymph
glands of the head and neck. When they are swallowed tuberculosis
of the digestive tract and the liver may follow as with primary infection
from without and simulate an infection of the food.

To what extent such auto-infection actually takes place it is impos-
sible to estimate, for any infection which has produced lesions within
the reach of the digestive tract may have come from without as well as
from the lungs. Itis probably of little significance when the discharged
material from the lungs is slight in amount. When it becomes very
abundant there may be extensive secondary disease of the intestines,
as in the case of No. 338 (page 46), in which the Peyer’s patches of the
small intestine were completely infiltrated with tubercles.

laws

A consideration which complicates any estimate of secondary infec-
tion is the varying susceptibility of different organs to infection with
age. The writer is inclined to the view that the region of the throat
and that of the smallintestine are more likely to absorb tubercle bacilli
early in life than later on, while the lungs seem to become with age the
preferred seat of the disease. The demonstration of this assumption
is complicated by the fact that calves are more exposed to food infection
than adult animals, because of the dangers of tubercle bacilli in the
milk. One point in favor of the increased immunity of the digestive
tract later in life isindicated by the absence of iesions in those animals
in which there is manifestly a discharge of tubercle bacilli from the
lungs. This is borne out by the cases included in Table I, in which
throat infection and lung infection are usually not associated together.
The whole subject is a difficult one and not of sufficient economic im-
portance at the present time to deserve much attention on our part.
Of more importance is the possible infection of the udder, through the
teats, from discharges of the same animal, especially the vaginal
discharges when tuberculosis of the uterus is present.

HEREDITY AND TUBERCULOSIS.

The transmission of the bacillus of tuberculosis from the parents to
the offspring before birth must be clearly distinguished from the trans-
mission of certain bodily conditions which favor the multiplication of
tubercle bacilli after infection.

The slow insidious progress of this disease in the infected body, its
apparent disappearance and subsequent reappearance after variable
periods of time, together with the somewhat peculiar modes of dissem-
ination of the bacilli within the body have made the investigation of
this subject unusually difficult. There are some pathologists who claim
that much of this disease is contracted before birth. The majority of
authorities are, however, inclined to the view that only very few cases
are the result of transmission before birth and that infection after birth
is the rule.

‘This subject is of special importance to us, for it is highly desirable
to know to what extent animals are born with the disease and under
what circumstances the transmission of the virus before birth is likely
to take place. A tuberculous calf is more dangerous than a tubereu-
lous cow, because it may carry foci of disease in the udder even before
this organ begins to secrete.

The tubercle bacillus may be conceived of as passing from parent to
offspring in several ways:

(1) It may pass in the semen of the male and infect the ovum directly.

(2) The ovum may be infected by disease of surrounding structures
(peritoneum, ovaries, Fallopian tubes) in the female.

118

(3) The fetus may be infected by the passage of tubercle bacilli from
the maternal placenta into the fetal cireulation.

As regards the two first-mentioned ways little need be said. As
shown by A. Geertner,* the possibility of adirect transmission of tubercle
bacilli from father to offspring is so slight that it need hardly be
taken into consideration. On the other hand, it has been shown by
Geertner that tubercle bacilli may pass from the mother into the ovum,
but this mode of infection must likewise be regarded as very rare.

The infection through the placenta is probably the most frequent
cause of congenital tuberculosis. It may take place when, in conse-
quence of generalized tuberculosis of the mother, tubercle bacilli are
in the circulation and become lodged in the placenta, whence, through
some ruptured vessel, they may pass into the blood of the fetus. The
same is perhaps even more likely to occur when the uterus has become
the seat of tuberculous changes either secondarily or primarily through
infection. To what extent tuberculosis of this organ must have pro-
gressed before conception ceases or the fruit fails to mature seems not
to be known.

It may be considered as definitely settled by experiment and obser-
vation that the bacilli may pass from the mother to the fetus under
certain conditions. The differences of opinion refer merely to the rela-
tive frequency of its occurrence. Baumgarten claims that with most
cases of tuberculosis among human beings the disease begins before
birth and is thus “inherited.” Geertner, +t after thoroughly sifting the
whole subject and enriching it with experiments of his own, comes to
the conclusion that in the human subject the tuberele bacillus fre-
quently passes from the mother to the fetus. He does not, however,
take the extreme position held by Baumgarten.

It remains for us to consider how frequently calves are born with
tuberculosis. Only a small number of cases of congenital tuberculosis
have been reported. Of these a few deserve mention.

In 1885 Johnet found tuberculous lesions in the liver, portal glands,
lungs, and bronchial glands of a fetus 8 months old. The mother
had been examined at the abattoir and found affected with advanced
pulmonary tuberculosis.

Malvoz and Brouwier§ have reported two cases of congenital tuber-
culosis. In both the glands at the hilus of the liver, the liver tissue
itself, and the:glands at the hilus of the lungs contained tuberculous
foci. The lungs themselves were intact.

Bang || found, in the course of extensive inquiries and personal obser-

* Ueber die Erblichkeit der Tuberculose. Zeitschrift fiir Hygiene, xu (1893), p.
101-251.

tLoe. cit.

{ Fortschritte der Medicin, 1885 p. 198.

§ Annal. de l'Institut Pasteur, 1889, p. 189.

|| Deutsche Zeitschrift f. Thermedicin, xvr (1890), p. 409.

GIES)

vations in Denmark, that congenital tuberculosis was not such a rare
occurrence after all. He presents three cases examined by him-
self. In the first case, a calf born dead, the glands at the hilus of the
liver contained cheesy-caleareous foci. In the second case, a calf pre-
sumably 2 days old, the liver, the bronchial, mediastinal, lumbar, and
perhaps other lymph glands contained cheesy-caleareous deposits. A
few were found in the lung tissue. In the third case, a calf about 14
days old, the liver, with portal glands, the lungs, with bronchial and
mediastinal glands, and one kidney contained tuberculous lesions.

Lungwitz* found in a fetus about 6 months old tuberculous lesions
in the lungs, liver, bronchial, mediastinal, mesenteric, and retroperi-
toneal lymph glands. The dam, about 10 years old, was affected with
generalized tuberculosis. including tuberculosis of the uterus and pla-
centa.

In a second case the dam, but 2 years old, was affected in the same
way as the first mentioned. The fetus, about 44 months old, was aftected
with generalized tuberculosis. Lesions were found in the liver, spleen,
kidneys, lungs, and corresponding lymph glands. The author adds
that in the Leipsic abattoir, where these cases were encountered, he
and Rieck had examined in all about 200 fetuses, which came from dis-
eased cows. The two cases reported were the only ones found. We
have thus but 1 per cent of transmitted disease in case of 200 pregnant
animals which failed to pass the inspection owing to advanced gen- —
eralized disease.

Quite recently Barlund t found two cases of congenital disease. Both
calves were about a week old when killed. ‘Calcified as well as fresh
tubercles were found in the lungs and lymph glands of thorax.

The occurrence of infection before birth is thus positively established
by theseacases; but have we any reason to believe that much of the
disease of later years is due to the transmission of tubercle bacilli in
the uterus?

The answer to this question must be based mainly on pathological
data-obtainable by the thorough post-mortem examination of a large
series-of cases. Animals in which the disease is already well advanced
are of but little service in the study of this question, since it is impos-
sible to trace definitely the place in the body where the bacilli first
began to multiply. The tuberculin tests furnish a considerable number
of cases in which the disease is in its earlier stages and still restricted
to one or more primary foci. To these we must look for aid in the
solution of this problem.

If we examine such cases carefully we shall find that usually the
lymph glands of the throat, the lungs, or the intestines are diseased.
These glands have been described in detail and their mode of infection
pointed out in a previous chapter. This consists in brief in the passage

* Archiv. f. wiss. u. prakt. Vhierheilkunde, xx (1894), p. 204.
t Centralblatt f. Bakteriologie, xv (1894), p. 498.

120

of one or more tubercle bacilli through certain tissues and their lodg:
ment and multiplication in the lymph glands into which the lymph
of such tissues drains. This peculiar settling down of tubercle bacilli
in case of so many infected animals in the glands which receive lymph
from organs or membranes in direct contact with the outer world (food
and air) is very good evidence that the tubercle bacilli are carried from
without inward. If they had been deposited in these glands by means
of the blood during the fetal period, the question arises why not in
other glands which after generalized infection appear equally ane
tible to disease ?

In a large number of cases of incipient disease the mediastinal or
the bronchial glands which receive lymph from the lungs are the only
diseased organs. Why should the virus localize in these glands by
preference unless they are the first places of deposit from the air drawn
into the lungs.

Theresis every reason to believe that most of the tuberculosis of
cattle is notstransmitted at or before birth, but is contracted later on in
lifebycontagion. Baumgarten, on the other hand, explains the isolated
disease of the lymph glands as inherited, because tubercle bacilli,
according to his views, can not enter the body without leaving some
disease at the point of entry. This phase of the subject has already
received some attention on page 108. We can not at present accept
Baumgarten’s theory, and believe that tubercle bacilli, may pass through
the lungs, for instance, by way of the lymphatics into the lymph glands
without causing visible disease of the Inngs themselves. Bang,* on
the other hand, is inclined to accept Baumgarten’s view and to regard
disease of the mediastinal glands as a result of congenital disease.

Not only does the location of the disease as stated above militate
against this view, but the occurrence of gland tuberculosis three or more
years after birth is quite common. Baumgarten would explain this as
a kind of latency of the virus, but in many cases the disease in full-
grown animals is still quite fresh. The writer recalls the case of a cow
7 years old in which the lesion was limited to one of the thoracic glands
in the youngest stage recognizable. The tubercles were distinct as
minute granulations, and under the microscope no necrosis could be
detected.

If all the cases of tuberculosis of lymph glands were to be accounted
for as the result of intrauterine infection nearly all bovine tuberculosis
must be regarded as congenital.

Since the probability of an intrauterine infection of the posterior
mediastinal glands is-much greater than that of the throat or mesen-
teric glands, it is worth while to examine for a moment the ways in
which the pulmonary glands may become infected from this direction.
It is conceivable that tubercle bacilli may become lodged during intra-
uterine life in the mediastinal glands by taking the following courses:

* Deutsche Zeitchrift f. Thiermedicin, xvi (1890), p. 409.

es da

121

*(h), Ehey may pass from the placenta directly into the right side of
the heart through the ductus venosus and thence to the lungs. Here
they may become filtered out of the blood and carried in the lymph
channels into the mediastinal glands.

(2) They may pass through the liver first, thence through the heart,
and then follow the course indicated under 1.

(3) They may pass into the liver, there become filtered out into the
lymph channels, in which they may be carried through the diaphragm
into the thoracic glands.

(4) They may be filtered out of the blood which passes through the
mediastinal glands.

Of these channels the last is hardly to be thought of when we bear
in mind what a minute percentage of the total blood passes through
the mediastinal glands at any given moment. Why other equally sus-
ceptible glands should not become affected at the same time seems
inconceivable. The third channel is so complicated that if it were
actually followed we should also expect to find tuberculosis of the
liver and the portal glands. ‘The first and the second seem the most
direct. As only a small portion of blood does not pass through the
liver, we might expect to find the liver or its glands (portal) in nearly
all cases of congenital disease affected together with the pulmonary
glands. In the cases cited above all but Barlund have reported tuber-
culous changes in the liver or its glands. In the tuberculosis of adult
life we find much tuberculosis of the mediastinal glands without corre-
sponding disease of the liver or its glands, a fact militating against
the foetal origin of the infection and in favor of inhalation as the real
channel.

A further argument against the theory of congenital tuberculosis as
a prominent factor is that drawn from statistics which demonstrates
an increase of the number of infected animals with age. Any latency
of the disease in calves is hardly acceptable, for it seems on the whole
more rapidly fatal in the voung than in the old.

The only fairly positive case of congenital tuberculosis which the
writer has encountered is that of a Jersey calf whose history is worth
recording here. The calf was born December 12, 1893. The mother
was recognized as being ill three months before. Her udder was nor-
mal. After penning the calf with her and allowing it to take as
much milk from the dam as it pleased for one month the dam was
killed. The calf was killed when 44 months old. It was appar-
ently in good health. The autopsy, however, tevenled a case of exten-
sive generalized tuberculosis.

Right knee fold gland contains a large caseous focus; left normal.

Left submaxillary gland contains a minute, entirely gritty focus, the right a large
caseous-calcareous focus. The postmaxillary glands contain a few small foci.

Extensive tuberculous deposits on the costal and pulmonary pleura and on the
pericardium. Great enlargement and necrosis of mediastinal and bronchial glands.

In the lung tissue a small number of recently necrosed foci one- half to three-

Fs fourths inch in diameter.

122

A few tubercles on omentum. The portal glands as large as hen’s egos, completely
necrotic, with much embedded calcareous matter. In the liver only a few small (one-
eighth to one-half inch) foci. On the capsule a few flattish excrescences. In the
spleen some necrotic tubercles one-fourth inch in diameter. One flattish tubercle
on capsule.

Renal glands tuberculous.

Meseatenre glands varying in size up to hen’s eggs; completely necrotic, with

caleareous particles.

While it is not to be denied that this calf may have contracted the
disease through the milk, yet the writer is inclined to look upon the
disease as contracted from the mother before birth, since the extent of
the disease is hardly explainable in any other way. The writer has also
seen several other cases of disease in animals not over 2 years old in
which the generalized infection, with but slight lesions at any one point,
suggested either congenital disease or infection very early in life. There
is, to be sure, no positive proof of congenital infection in such cases, but
the wide dissemination of tuberculous lesions at an early age is very
suspicious when we bear in mind that ESSE ES becomes ccna
only after prolonged local disease.*

Among those who have given this subject considerable attention
Nocard is inclined to regard congenital disease as uncommon and safely
left out of account in considering means of prevention. The writer is
inclined to accept the same view from an independent study of this
question. The best view to take of this subject is the one suggested by
Gaertner, that congenital tuberculosis or the transmission of tubercle
bacilli from the mother to the fetus is but one of the many ways in
which the virus is disseminated. Circumstances at times may contribute
to more, at times to less, infection of this kind. There is no doubt that

*After this article had left the writer’s eae a pecunate case of inion infec-
tion, much more convincing than the one referred to in the text, was dissected. A
brief description here is justifiable on account of the comparative rarity of such
cases.

A cow, about 5 years old (No. 268 in Table V), was killed in an extremely emaci-
ated state twenty-one days after giving birth to a calf. The autopsy showed very
extensive, probably primary, disease of the lungs and pulmonary glands. From the
lungs the coughed-up tubercle bacilli had recently invaded the retropharyngeal
and the mesenteric glands. The portal system was also infected.

The pleura had become involved by contiguity with the lung disease and thence
the peritoneum had become affected. Blood infection was indicated by slight dis-
ease of both kidneys.

In the left horn of the uterus an area about 2 to 3 inches square was involved. The
wall was much thickened and on section aggregations of tubercles were found in the
submucous tissue, some with necrotic centers. About six of the cotyledons were
involved.

The calf killed at the same time (21 days old) showed unequivocal marks of con-
genital tuberculosis. The lesions were limited to the liver and its glands, one kid-
ney and its gland, and two posterior mediastinal glands. The tuberculous masses
were in all cases necrotic and calcareous centrally.

It seems that the disease of the uterus in the mother was older than three weeks.
The calf was probably infected from this focus before birth.

123°

if tuberculosis should be allowed to increase uncontrolled in the future
as in the past congenital tuberculosis will increase in frequency and thus
at the very beginning of life lay the foundations for a disease which
under this form will render the affected animal a great menace to pub-
lic health as well as a dead Joss to agriculture.

Mueh has been said and written concerning the inheritance of a cer-
tain combination of bodily characters which increase the chances of
the subject to contract the disease when exposed to it or which tend
to amore rapid course of the disease after it has once gotten a foothold
in the body. It is an exceedingly difficult subject to discuss, because
we know little or nothing definite about it. Theoretically there seems
to be no reason why some animals or breeds should not be more sus-
ceptible than others, but the conditions under which observations can
be made to prove or disprove this theory are complex and likely to
bring out erroneous conclusions. The element of contagion. is such a
prominent factor at all times that individual or racial susceptibility
can not be studied satisfactorily until it can be suecessfully controlled.
Inherited susceptibility is also not separable from acquired suscepti-
bility due to depressing environment and unsuitable food.

A more satisfactory method of approaching the subject would be the
experimental inoculation of individuals from different breeds, chosen as
nearly alike as possible, and a careful study of the progress of the
induced disease. Such experiments, though expensive both as to time
and money, might throw more light on the subject of tissue immunity
than prolonged observation of the disease as acquired naturally. If,
however, the disease can be controlled by weeding ont all tuberculous
animals from a herd at certain regular intervals and thus removing
the element of contagion entirely, the question of heredity of disposi-
tion will no longer be of any practical importance, for there can be no
tubercles without the tubercle bacillus.

THE DIFFERENTIAL DIAGNOSIS OF TUBERCULOUS LESIONS.

In the recognition of tuberculosis at the post-mortem examination
errors may be made in two directions: Certain alterations in the tis-
sues which are tuberculous in character may be overlooked and certain
changes may be pronounced tuberculous which are due to other causes.

The peculiar tissue reaction which leads to the formation of minute
tubercles, their coalescence, and the subsequent caseation or calcifica-
tion of the mass of new tissue formed thereby, needs not be seen fre-
quently by a trained eye before their characteristics are firmly impressed
on the mind. There is, furthermore, the constantly recurring affection
of the lymph glands either with or without disease of the vital organs
which belongs to no other disease of cattle.

It may, however, occur now and then that the disease process is so
recent that the changes induced are too slight to be detected by the

124

naked eye. The earliest visible manifestations in the lymph glands
are seen on the cut surface as whitish patches, having, when viewed in
a good light, a slightly granular appearance. Simple hyperplasia of
the lymph glands in which the follicles appear on the cut surface as
smooth, whitish, slightly elevated, round patches must be carefully dis-
tinguished from early tuberculous lesions. This hyperplasia is simply
an increase in the number of lymph cells composing the follicle, and is
especially conspicuous in young animals. In these the glands lack the
pigment markings which appear later on in life, and the uniformly whit-
ish appearance of the cut surface may erroneously suggest tuberculosis.
It is not to be denied that the beginnings of tuberculosis may now and
then lurk in these follicles, but after somewhat extensive examination
of sections of such regions and a uniformly negative outcome, the writer
is inclined to believe that they may safely be passed over.

Mistakes are more likely to occur by confusing lesions due to other
bacteria, to parasites, and to traumatism with those of tuberculosis,
unless a certain amount of caution and reserve is exercised and the aid
of the microscope or of those especially trained is invoked.

3acterial lesions, which resemble tubercles closely and which go to
make up the pathological condition known as pseudo-tuberculosis, have
been found among sheep and smaller animals, but not among cattle.
A general review of this subject will be found in Bulletin No. 6 of the
Bureau of Animal Industry (pp. 87-95), to which the reader is referred.

Forms of broncho-pneumonia may now and then simulate tuberculo-
sis of the lungs, but the characteristic distribution, as described on page
91, will generally assist in making a prompt diagnosis. One of these
forms of pneumonia has been described by Kitt * who found in sections
of the lung tissue masses of a specific bacillus. The various cases of
broncho-pneumonia examined by the writer were so readily distinguish-
able from tuberculosis that any remarks would be superfluous. Among
the more common as well as more perplexing lesions frequently found
in cattle, those due to entozoa stand first and deserve a more detailed
description.

WORM NODULES IN THE SMALL INTESTINE.

-'These have been looked upon as the result of true tuberculosis im sey-
eral cases which have come to the writer’s notice. They are very com-
mon in the region about Washington. The writer has also seen them
in New York. In tissues from cattle slanghtered at Chicago they were
likewise recognized. Itis highly probable that they are widely dissemi-
nated in our country.t

*Eine bacilliire Pneumonie beim Rinde. Monatshefte fiir praktische Thierheil-
kunde, 1 (1890), p. 145. '

t They have been noticed by Dr. Arango in Colombian (South American) cattle.—
The Veterinary Journal, 1894, p. 105.

125

They may be readily seen by the naked eye, but their relative abund-
ance is more easily determined by passing the intestine either slit open
or still uncut through the hands. The intestinal wall then feels as if
beset with shot-like bodies. When the tube is slit open, the mucous
membrane appears elevated by small hemispherical tumors varying in
size from barely visible nodules to bodies as large as peas or even larger.
These tumors are, aS a rule, isolated. Rarely several are close together.
Only in very extensive infection of sheep are they frequently so abund-
ant as to form by their aggregations large elevated patches or beds.
They are not all of the same size in the same animal, but vary as stated.
If we examine these projections more closely we shall find that in all
but the smallest ones the center appears opaque and yellowish. This
yellow nucleus is more or less irregular in outline. The mucous mem-
brane covering them is unharmed except as to the presence of a little
depression on the summit of the nodule, which is probably the point of
exit of the once encysted worm. This opening may be in the center of
a bluish spot, probably the débris of a hemorrhage, caused by the out-
ward-moving worm. In the larger nodules a slight pressure forces from
this minute opening some of the softened contents of the cyst.

The situation of the nodules is in the submucous tissue. The mucous
membrane may be scraped away and leave the nodule intact. When a
small one is teased out of its surroundings and crushed between two
Slides the parasitic worm, about 1 mm. (;!; inch) long and almost invisi-
ble to the unaided eye, may be detected in some cases. The larger the
nodule is the less likely the search for the worm will be successful.

The larger tumors, usually about one-fourth inch in diameter, consist
of athin, smooth capsule containing putty-like substance of a yellowish
or greenish-yellow color, easily removed. In very old tumors the thin
capsule may inclose a calcified mass of very irregular surface.

In some cases most of these intestinal tumors have a decided bluish
color. This is probably due to some former hemorrhage, as suggested
above.

These tumors may be distinguished from true tubercles in a variety
of ways. In the first place, tuberculosis of the mucous membrane of
the intestines is quite rare. The writer has seen but one case in 150
tuberculous animals. In this the Peyer’s patches were involved.*
Infection by way of the intestines shows itself mainly in the mesenteric
glands. Any affection of the mucous membrane without disease of
these glands must be looked upon with suspicion. This worm affec-
tion is, furthermore, very common in certain regions, and usually affects
all anunals alike.

‘The character of the worm tubercleis quite different from that of the
true tubercle. Setting aside the recognition of the worm, which is pos-
sible only in young tumors, we have sufficient points of difference to
make a diagnosis with the naked eye possible in most if not in all

*See autopsy notes of No, 338, p. 46.

126

eases. The contents of the worm tubercle is made up of leucoeytes
entirely, whereas the brittle, cheesy contents of the true tubercle is
usually a mass of granular and fatty detritus. With the true tubercle
there is usually more or less change in the immediate surroundings of
the tubercle. The wall is infiltrated and thickened and shades both
outwards and inwards. Smaller tubercles are also frequently found in
the tissue around the large fueus. In the worm tubercle the capsule is
thin, sharply defined, and quite independent of the contents, which are
easily removed. Finally, the characteristic histological structure of
true tubercles enables us to decide with the aid of the microscope
should other simpler means fail. 5

OTHER LESIONS SIMULATING THOSE OF TUBERCULOSIS.

Parasitic lesions of the mesenteric glands are not uncommon in the
region about Washington. How widely distributed they may be the
writer is unable to state from present information. They simulate the
lesions of tuberculosis, but are as a rule distinguishable from them on
close scrutiny. They resemble somewhat those of the intestinal walls,
and the writer was inclined to consider them caused by the same para-
site when in the spring of 1895 their true cause was revealed tous. At
that time Dr. E. C. Schroeder, in assisting the writer at autopsies of
the Soldiers’ Home herd, was cutting open the mesenteric glands sys-
tematically in search for tuberculosis. He noticed a small parasite
quickly crawling out of some cavities exposed by the knife. A close,
naked-eye examination showed the characters of Linguatula (Pentasto-
mum) tenioides. The material was handed over to Dr. Stiles, zodlogist,
for further study.

The cavities made by these organisms are at first mere excavations
of the gland tissue and are filled with a blackish mass made up of the
pigmented débris of the gland tissue. In later stages they become
filled up with a cheesy matter which finally becomes calcified. They
vary in shape and size, and rarely exceed one-fourth inch in diameter.
They are separated from the gland tissue by a thin capsule. This is
completely filled with the cheesy matter, which is entirely homogeneous,
greenish in color, and putty-like in consistency. In this stage the mass
is shown to be made up entirely of leucocytes.

The later stage is characterized by the calcification of the contents
into a stone of irregular surface crushed only when considerable force
is used. The stone is easily pulled out of its capsule, which it fills
completely. These hard masses are frequently situated directly under
the cortex and sometimes project above the gland surface.

These gland nodules are thus readily distinguished from true tuber-
cles by their contents. In the latter the necrosis is not uniform, and
the resulting caseous mass occupies only a portion of the neoplasm and
shades into the peripheral, still firm and organized zone of the tubercle,

127

The contents are therefore not removable in toto, except after com-
plete softening and circumscription of the tuberculous process. The
cheesy mass is, moreover, mainly fatty and granular débris. With
true tuberculosis an extension of the process is usually noticeable; with
worm tubercles this is not the case, the capsule is directly contiguous
with healthy gland tissue, and all evidence of encroaching infiltration is
absent.

Isolated tubercle-like lesions are found occasionally under the cortex
of the liver, which are probably of parasitic origin. Unless tubereu-
losis has been plainly recognized in the glands at the hilus or elsewhere
in the body, the diagnosis should be left open until such nodules have
been examined under the microscope.

Yellow patches, due to fatty degeneration, may appear on the margin
of the liver, probable as a result of embolism. Though they resemble
more or less closely the necrotic patches of the tuberculous liver in
guinea pigs, they contain no traces of the tuberculous process. In
gereral tuberculous foci in the liver of cattle are roundish and provided —
with a thick, dense, connective tissue wall.

The meer cance of a correct diagnosis of tuberculosis of the udder
makes it imperative that mistakes be avoided in determining the nature
of any abnormal appearances on post-mortem examination. It is essen-
tial that statistics of udder tuberculosis be accurate, for it is upon them
that the future action of sanitarians will be largely based in dealing
with this disease. It is highly probable that udder tuberculosis when-
ever encountered will be generally recognized as such. It is equally
probable that other changes may now and then be called tuberculosis.
In this connection attention should be called to the aberrant appear-
ances occasionally presented by the freshly-cut surface of udder tissue.
The usual pinkish surface is, in some cases, variegated by patches of
yellow representing foci of intense fatty changes. In portions which
have lost the power to secrete the increase of connective tissue com-
presses the lobules and gives the cut surface a granular appearance
which might be mistaken for tubercular infiltration. Very deceptive
are certain yellow nodules which project above the cut surface. They
are lobules distended with fat and have the normally soft consistency
of udder tissue. In any case of suspected udder tuberculosis the |
tubercle bacilli should be demonstrated, or else the histological strue-
ture of tubercle determined in sections of hardened tissue.

Another set of deceptive lesions frequently encountered at autopsies
of cattle are those due to the action of foreign bodies swallowed with
the food. The frequency with which this is observed and the exten-
Sive, often fatal, injuries which are induced thereby, ought to impress
cattle-owners with the necessity of carefully protecting their herds from
such calamities.

The lesions due to foreign bodies are usually situated on the second
stomach (reticulum) in the form of enlargements or tumors, varying in

128

size up to an orange. The smaller ones have an almost cartilaginous
hardness, and when incised a small amount of creamy pus is found in
the center. Inthe larger ones the capsule is equally dense but not so
thick relatively. They also contain the homogeneous creamy pus,which
usually has a penetrating but not offensive odor.

These abscesses are associated with more or less increase in the con-
nective tissue and the binding down of the ventral or narrower end of
the liver to the diaphragm. This condition is so common that the writer
has seen very few older cows without attachments of the-liver to the stom-
ach. The situation of the abscesses described, their consistency and
contents are sufficiently characteristic to prevent any errors of diag-
nosis, if attention has been once called to them.

Foreign bodies not infrequently work their way into the thoracie
cavity where they may produce abscesses in the lung tissue. These are
readily distinguishable from softened tuberculous foci by their relation
to adhesions of thelungs to the diaphragm and subphrenic lesions. Such
abscesses are also associated with hyperplasia of the interlobular tissue
of the surrounding lung tissue and firm red hepatization of the latter.
Cavities due to tuberculosis are as a rule surrounded by a zone of
easily recognizable fresher tubercle eruptions, which at once place the
nature of the cavity beyond doubt.

SOME PRACTICAL SUGGESTIONS FOR THE SUPPRESSION AND PREVENTION OF
TUBERCULOSIS.

By THEOBALD SMITH.

In endeavoring to seek appropriate means for the suppression of this
disease, we find ourselves confronted with conditions quite different
from those obtaining for most other infectious diseases. These condi-
~ tions are in brief as follows:

(1) The present wide dissemination of the disease, no territory being
absolutely free from it.

(2) The large percentage of infected cattle which are in the earliest
stages of the disease, or in which the lesions are insignificant, station-
ary, or healed.

(3) The absence of disturbances of health for considerable periods of
time after infection.

(4) The possible transmission of tubercle bacilli from cattle to man,
more particularly in the milk.

Nearly all of these peculiarities have their source in the slowly and
insidiously progressive nature of the affection which prolongs the
duration of the disease from days to months and years. It is this
character which makes the complete eradication of bovine tuberculosis
a work of huge proportions, involving serious financial sacrifices.

In the following pages the subject of prevention is dealt with as it
may be applied by the individual stock-owner, since this disease, more
than any other, needs the combined efforts of individuals for its restric-
tion. It makes the greatest havoc in the herd in which it exists, and
rarely travels to other herds, excepting in the diseased animal which is
purchased or exchanged. It is,in fact, possible for each herd-owner to
protect himselt quite successfully from outside infection, as is shown in
the following pages which treat of the contagiousness of the disease,
the removal of affected cattle, and some general sanitary measures.

THE CONTAGIOUSNESS OF THE DISEASE

Is linked to the tubercle bacillus. Without it, tuberculosis can not
develop. Hence, our knowledge of the transmission of the disease is
derived largely from what we know of the life history of the tubercle

bacillus within and without the animal body.
129
2891—No. 7——_9

130

We have seen in the foregoing chapters that tubercle bacilli may pass
from the diseased animals in one or more of the following ways:

(1) In discharges from mouth and nose in case of advanced lung dis-
ease, or of disintegration of enlarged throat glands. (Disintegrated
parotid, postmaxillary, and submaxillary glands may discharge exter-
nally.)

(2) In discharges from bowels in advanced stages.

(3) In discharges from vagina in case of tuberculosis of the uterus.

(4) In milk when the udder is tuberculous or the disease generalized.

(5) From the mother to the fetus in case of tuberculosis of the uterus
or advanced generalized disease.

We have also seen from investigations of others and of our own that
infection of cattle oceurs in the following ways:

(1) Fully nine-tenths of all diseased animals have been infected by
inhaling the tubercle bacilli, dried and suspended in the air.

(2) Fully one-half of all diseased animals have been infected by tak-
ing tubercle bacilli into the body with the food. Frequently both food
and air infection are recognizable in the. same animal.

(3) Animals are infected, though rarely, during copulation. In such
cases the disease starts in the uterus and its lymph glands or in the
sexual organs and corresponding lymph glands of the bull.

(4) Perhaps from 1 to 2 per cent of all calves are born tuberculous.

We may define the dangers of infection somewhat more definitely by
the statement that in any herd, even in those extensively infected, only
asmall percentage of the diseased animals, namely, those which are
in an advanced stage, or such as have the disease localized from the
very beginning in the udder, or the uterus, or the lungs, are actively
shedding tubercle bacilli. It is these that are doing most, if not all, of
the damage by scattering broadcast the virus.

Disease of the udder is particularly dangerous, because the milk at
first appears normal for some weeks and therefore would be used with
impunity. Moreover, the tubercle bacilli in the diseased gland tissue
are unusually numerous.*

The owners of cattle should thus pay special attention to the condi-
tion of the udders. Any which are found to increase slowly in size
without any indication of inflammatory processes recognizable by the
presence of heat, pain, and redness, and which become very firm with-
out showing at first any alteration in the appearance of the milk, should
be promptly segregated and the entire milk rejected until a diagnosis
can be made by a veterinarian.

Similarly in tuberculosis of the uterus the vaginal discharge may
contain many tubercle bacilli. This, deposited anywhere, may lead to
the extensive dissemination of the virus, or it may be carried by the

* This fact, mentioned by Bang, the writer has had the opportunity to confirm in
case of two tuberculous udders examined recently.

131

bull to other cows. A diagnosismay be made by the examination of
the discharge for tubercle bacilli.

The foregoing statements apply to individual herds only. To what
extent does the danger extend beyond the diseased herd to others in the
neighborhood? To this we may give the general answer that there is
no danger unless the animals mingle on the pasture or in the stable.
Tubercle bacilli are not carried in the open air, or if they are, their
numbers are so small that the danger of infection is practically absent.

It is also highly doubtful whether they are ever carried in sufficient
numbers by third parties from place to place to become in any sense a
danger. The reasons for this must be sought for in the tubercle bacil-
lusitself. The diseased cow is the only manufacturer of tubercle bacilli*
as well asthe chief disseminator. Tubercle bacilli after having left the
body of the cow (and usually in small number) do notincreasein numbers
in nature but suffer a steady decrease and final extermination ,in four
to six months at the longest. Only after they have entered the
bodies of susceptible animals do they again begin to multiply. Hence
with this disease the only danger to other herds lies in direct contact,
or in the transfer of a diseased animal or of milk from such an animal.
The greatest danger exists in the immediate surroundings of the in-
fected and loses itself as the distance increases.

REMOVAL OF DISEASED ANIMALS.

In order that any infectious disease may be effectually controlled it
becomes of the utmost importance to recognize in the living animal not
only advanced stages but even the slightest infection. This essential
requirement seems to have been found in tuberculin. In the first
article of this bulletin (pp. 7 to 74) the reader will find a detailed state-
ment of its uses. The writer wishes to add here only a few remarks
from a pathological point of view. Extensive use of tuberculin in
Europe and in this country has shown that in a certain percentage of
healthy animals a high reaction may follow the injection of tuberculin.
On the other hand a small percentage of animals which fail to react
show tuberculous lesions at the autopsy. How are we to interpret
these inconsistencies?

Nocard, a prominent French authority,t is moved to state that an
elevation of temperature of 2 or more degrees Fahrenheit after the
injection of tuberculin invariably means infection, and that if lesions
are not found at the autopsy this has been badly performed. Most
German authorities are not inclined to accept the infallibility of tuber-
culin. The writer sides with the latter, for he has failed to detect dis-
ease after hours of searching in some cases. In several others which

“Other domestic animals may now and then be tuberculous, but this danger is
hardly worth considering at present.

+t Congres pour l’étude de la tuberculose chez homme et chez les animaux, 1894,
p. 22.

132

gave no reaction the lesions, though slight, were as marked as in others
in which a high fever reaction had been obtained.*

It is not to be denied that in the one class of cases the lesions may
be so slight, the changes so recent, that they escape attention, and that
in the other class the lesions, which are usually quite restricted, are
undergoing a healing process. However, we have not yet reached that
stage of information which will permit us to explain satisfactorily these
discrepancies, and hence we can not as yet unqualifiedly accept the
infallible action of tuberculin, and we must content ourselves with the
statement that it is a diagnostic agent of very high power.

Accepting the great value of tuberculin in revealing tuberculosis not
recognizable by any other means during the life of the animal we are
confronted by the necessity of segregating those animals which have
reacted with a high temperature and either curing or slaughtering
them.

The cure of tuberculosis with tuberculin has been attempted by a
small number of observers. Frequent injections of small doses into
guinea pigs were made by Pfuhl} and by Kitasatot with the result that
while the disease was greatly prolonged in some animals a cure was not
attained. Others have attempted to heal experimental tuberculosis of
theeye inrabbits. The most prolonged observations made by Trudeau§
in this country have shown that while a cure may be apparently
brought about a relapse is likely to occur at any time. With cattle
the case is somewhat different. If tuberculin could be made to point
out those numerous cases in which the disease is restricted to one or
more small foci in the lymph glands a course of treatment with injec-
tions of tuberculin might be successful in stimulating the body to a
speedy healing of these foci. But in selecting tuberculous animals
with tuberculin it is quite impossible to discover how much disease is
present. To treat any but the most incipient cases would be worse
than useless. The same objection would hold for any other remedy
likely to be introduced. The treatment of this disease is not to be rec-
ommended, therefore, and other means of disposal must be sought.

Nocard, || in view of the fact that many animals which give a marked
tuberculin reaction have only insignificant lesions in the body, recom-
mends that all such as give a distinct reaction be rigorously quarantined
from the rest of the herd. The healthy animals should be placed in
thoroughly disinfected stables and new animals admitted only after
they have successfully passed the tuberculin test. He further recom-
mends the prompt fattening for slaughter of the infected animals which
are in good condition. The lesions will be so slight, he adds, that no

* See Nos. 319, 322, 334, 360, pp. 39 to 56, and D, Table LV.

t Zeitschrift f. Hygiene, x1, p. 241.

; Zeitschrift f. Hygiene, X11, p. 321.

§ Trans. of the Association of Amer. Physicians, 18938, 1894.
|| Loe. cit.

133

inspector dare demand the seizure of the meat at the abattoirs. Dur-
ing the fattening they may be used as before the test. The preventive
measures recommended by him thus comprise the tuberculin test with
segregation of the infected animals. ‘These must not be used for breed-
ing nor must they be sold, exchanged, or given away. The owner can
only give them up to the butcher.

If we accept Nocard’s view of the infallible action of tuberculin his
suggestions require no amendment. We are not inclined to accept it
at present, however. Hence it is essential that the tuberculin test be
repeated not later than after an interval of six months, so that it may
reveal any cases not detected at the first test. Future repetitions are
equally important, as the disease germs may possibly be introduced
later on by tuberculous human beings, or by tuberculous cats, dogs, and
other domesticated animals.

In the absence of the tuberculin test or of organized official inspec-
tion, the stock owner should carefully and promptly remove from his
herd and have destroyed:

(1) All animals which show emaciation with coughing and any sus-
picious discharges from the nose.* |

(2) Those animals with enlarged, prominent glands about the head
(in front of the ears, under and behind the lower jaw), or enlarged
glands in front of the shoulder, in the flank, and behind the udder.

(3) Animals with suspected tuberculosis of uterus and udder.

GENERAL SANITARY MEASURES.

It will probably require more or less time before the use of tuber-
culin will have become generally established. Hence preventive meas-
ures of a general character must still be kept in view for some time to
come. These measures partly suffer shipwreck from the fact that it is
often difficult to recognize even advanced disease during life. Still,
much can be done to reduce the amount of infection by following out
certain general and specific. suggestions which the renewed study of
the disease has either originated or else placed on a more substantial
basis.

Perhaps the most important preliminary suggestion to be made is
that the owner of cattle should endeavor to familiarize himself as much
as possible with the general nature of tuberculosis, its cause, the ways
jn which the virus may leave the body of the sick and enter that of the
well, and, lastly, the ways in which it spreads within the body. He will
by the acquisition of such fundamental knowledge lift himself above
the plane where quackery and specifics abound, and understand pre-

*Now and then emaciation is due to other causes, such as the presence of foreign
bodies in the chest, parenchymatous disease of liver and kidneys, chronic broncho-
pneumonia, etc. Animals affected with these diseases are of no permanent value,
and their destruction is, in the end, an actual saving, since such maladies are not
curable.

134

cisely what to expect after the disease has entered his herd and how
to meet the demands of public health. He should, moreover, make
himself aéquainted with the peculiar appearance of tuberculous growths
in the body and open every animal that dies, so that, he may know to
what extent his animals are dying of this malady. Wherever possible
the services of a skilled veterinarian should be made use of. Sanitary
precautions should begin with the removal of diseased and suspected
animals, as stated above. This is the most essential requirement, for
diseased animals are the only breeding places of the specific virus.

After the removal of these, attention should be paid, first of all, to
the stables. Here during the iong confinement in the winter months
we may look for most of the inhalation disease so common in tuber-
culous cattle. Even when only a few cases of tuberculosis. have been
found the stables should be disinfected by removal of all dirt and the
subsequent application of disinfectants. Since tubercle bacilli are
more resistant than most other disease germs the strength of the dis-
infecting solution must not be less than as given. The following sub-
stances may be used:

(a) Corrosive sublimate (mercuric chloride), 1 ounce in about 8 gal-
lons of water (one-tenth per cent). The water should be kept in wooden
tubs or barrels and the sublimate added to it. The whole must be
allowed to stand for twenty-four hours, so as to give the sublimate an
opportunity to become entirely dissolved. Since this solution is poison-
ous it Should be kept covered up and well guarded. It may be applied
with a broom or mop and used freely in all parts of the stable. Sinee
it loses its virtue in proportion to the amount of dirt present, all manure
and other dirt should be first removed and the stables well cleaned
before applying the disinfectant. After it has been applied the stable
should be kept vacant as long as possible. Before the animals are
allowed to return it is best to flush those parts which the animals may
reach with their tongues to remove any remaining poison.

(b) Chloride of lime, 5 ounces to a gallon of water (4 per cent). This
should be applied in the same way.

(c) The following disinfectant is very serviceable. It is not poisonous,
but quite corrosive, and care should be taken to protect the eyes and
hands from accidental splashing:

Crude ‘carbolic acid..2 22 .siost sis ba eee eee See ee .-- 4 gallon.
Crude sulphuric acidy-..253 3242) 55 eee eee 4 gallon.

These two substances should be mixed in tubs or glass vessels. The
sulphuric acid is very slowly added to the carbolic acid. During the
mixing a large amount of heat is developed. The disinfecting power
of the mixture is heightened if the amount of heat is kept down
by placing the tub or glass demijohn containing the carbolie acid in cold
water while the sulphuric acid is being added. The resulting mixture
is added to water in the ration of 1 to 20. One gallon of mixed acids
will thus furnish 20 gallons of a strongly disinfectant solution having
a slightly milky appearance.

135

(d) Whitewash is not In itself of sufficient strength to destroy tuber-
ele bacilli, but by imprisoning and inecrusting them on the walls of
stables they are made harmless until destroyed by prolonged drying.
Whitewashing should be preceded by thorough cleansing.

Particular attention should be paid to the sides and ceiling of
stable. All dust and cobwebs should be periodically washed down.
Those parts coming in contact with the heads of cattle, stanchions,
halters, troughs, etc., should be frequently cleansed and disinfected,
even when they have not been used by avowedly diseased cattle.

The removal of virus from the stables should furthermore be pro-
moted by the prompt removal of manure and by abundant ventilation.
Good air has the effect of diluting infected air and thereby reducing
the chance of inhaling dried, floating tubercle bacilli, or at least of
reducing the number to be inhaled. It likewise improves the vigor of
the confined animals and hence increases the resistance to infection.

Cattle should not be placed so that their heads are close together;
each animal should have plenty of room,* and occupy the same place in
the stable at all times. These precautions will prevent the nasal, lung,
or vaginal discharges of one animal from striking the head or soiling
the feed of another. It is true that it is impossible to prevent animals
licking each other, but it should be remembered that prevention must
begin with the removal of all cases which are suspected of discharging
tubercle bacilli. Stables should, furthermore, be carefully protected
from the expectorations of human beings affected with tuberculosis of
the lungs.

Cattle should be housed as little as possible. The pasture has the
effect of greatly reducing the chances of infection by a more or less
rapid destruction of the virus, as well as by increasing the vigor of the
animals through muscular exertion in fresh air. To what extent ani-
mals may pick up the virus on fieids it would be difficult to estimate.
That itis perfectly possible can not be gainsaid. A tuberculous animai
may soil the ground over which it passes, and other animals may take
up the virus with the food soon after.

It isnot likely that the virus remains alive long enough on the ground
to become dried and ready for inhalation. The action of sunlight, the
alternate wetting and drying which goes on in nature, may be looked
upon as destructive agents. Hven if the tubercle bacilli became speed-
ily dried, the great diluting effect of the open air would reduce to a
minimum the chances of inhaling the virus.t

Among the other dangers to caution against is the infection of food
and water. Drinking troughs should be so arranged that the surface

*Each cow should have at least 600 cubic feet of air space.

tIf infection takes place in the open air, it would probably be food infection.
Observers in making autopsies of cattle living chiefly out of doors should pay par-
ticular attention to the primary focus of infection, in order that some positive infor-
mation on this important subject may be obtained.

: 136

water is constantly flowing away. Discharges from the nose or mouth
left floating on the surface may be drawn in by healthy cattle while
drinking. Each person must, in such eases, use his own judgment
and ingenuity to prevent infection in accordance with the quantity of
water at his disposal.

To restrict the dissemination of the disease among young stock,
the safest plan is to bring skimmed milk and other dairy products to
the boiling point before feeding them. If the cows are positively known
to be healthful this may be unnecessary, but where any doubt exists
the heating should be resorted to. Such a precaution will, further-
more, reduce scouring among calves, whichis probably due, in a great
measure, to bacteria in the food.

In presenting the foregoing suggestions, the writer has endeavored
to keep in view two conditions: (1) That in which tuberculin is not
within reach and only unusual watchfulness can be exercised in sepa-
rating suspected animals from the healthy, and (2) that in which tuberen-
lin is tried, but with the view that itis not wholly infallible and requires
to be seconded with other precautionary measures. If tuberculin is
infallible most of the suggestions made fall to the ground as unneces-
sary unless the disease can be readily reintroduced by man or diseased
animals of other species—a possibility of wholly unknown dimensions
at present.

Thesesuggestions might be criticised because they tacitly assume that
a herd can live and thrive even when tuberculosis is present. This
criticism may be answered by the fact, experimentally demonstrable,
that the introduction, into the body of the very susceptible guinea pig,
of different numbers of tubercle bacilli is followed by a rapidly or a
very slowly progressive disease, according to the quantity of virus.
Hence, if, even where tuberculosis is present and not recognizable, ail
precautions are taken to reduce in every possible way the number of
tuberele bacilli in the air, the food, and the milk, it is evident that if the
experimental data are accurate, the amount and intensity of disease
may be reduced and possibly the unavoidable, slight infections become
healed. It isnot the purpose of the writer to make the neglect of the
tuberculin test justifiable, but it is evident that, with the present great
prevalence of tuberculosis, all means must be resorted to to keep the
disease from making stillfurther inroads. The more conservative such
means the more likely are they to find favor. The amount of disease to
be combated, the large financial resources required by more radical
measures, makes it probable that the measures suggested will have to
be kept in operation for an indefinite time to come.

The study of tuberculosis, though prosecuted for many years, bas still
many problemsof prevention to solve, especially those which pertain to
the conditions underlying predisposition. Is the breed or descent of the
animal of much importance, or isit the conditions under which each ani-
malis compelled tolive which determine the readiness with which the dis-

137

ease destroysthe body? These are vital questions, and their answer must
have an important modifying influence on the future success of dairying
and stock-raising. As we are now entering upon an era of suppression
of this disease, it should be borne in mind that radical measures 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 froin the lapses of tuber-
culin, from sources of the virus outside of the bovine species, and from
heredity, breed, and environment as predisposing agents.

TUBERCULOSIS AND THE PUBLIC HEALTH.

Much of the difficulty which arises when radical measures for the
suppression of this disease are discussed is the economic value of the
products of cattle, the meat and themilk. The somewhat heterogeneous
views prevailing in this country concerning the use of the flesh of ani-
mals having but trifling tuberculous lesions are offset by the pretty
_ definite attitude of European authorities, who claim that the meat from
incipient cases. of tuberculosis is entirely fit for food. This attitude
enables Nocard in his recommendations to suggest the prompt fatten-
ing of allinfected animals for the butcher. This difficulty has been
solved temporarily in this country by turning the flesh of cattle which
gave a reaction after the tuberculin test, even when the lesions were
insignificant, into fertilizers. How far such destruction of food is
called for in the interests of sanitation and sentiment is a question which

must be left for future discussion and the wealth of the country to
settle.

The use of the milk from infected animals is 4a question difficult to
deal with when we consider on the one hand the clamors of public
health and on the other those of the dairyman who finds it temporarily
impossible to maintain his business if a large number of animals are at
once withdrawn from his herd. It will be observed that Nocard does
not forbid the use of the milk of incipient cases. Here also he avoids
the stumbling block of reform in dairy matters by not making restric-
tions unnecessarily severe.

In order to obtain more information on the presence of tubercle
bacilli in milk the work reported by Dr. Schroeder on pages 75 to 87 was
undertaken as a continuation of former investigations already pub-
lished in Bulletin No. 3. These investigations, so far as they refer to
single animals, confirm those of all former observers, that the milk of
tuberculous animals is not so frequently infected as has been supposed.
It may be laid down as a general rule that the milk of animals in the
earliest stages of tuberculosis and with perfect udders does not contain
tubercle bacilli. Only such as show signs of labored breathing and
of emaciation, such as have enlarged external glands, or some difficulty

138

with the udder or the uterus,* should be looked upon with grave suspi-
cion and their milk excluded at once from sale. If these extenuating
circumstances be borne in mind by the public health officials much hard-
ship may be now and then avoided and the work of extermination of the
disease be carried on more smoothly and more effectually in the end.

Another phase of this question which should not be overlooked is
the relative danger of the air of cow stables to human beings. If more
than three-fourths of all tuberculous cattle have been infected through
the air of cow stables why is not the air of stables equally dangerous
to human beings frequenting them? It would certainly be of interest
for public health officers to look into this matter more closely.

TABLES SHOWING THE DISTRIBUTION OF TUBERCULOUS LESIONS IN
THE BODY OF INFECTED CATTLE.

In the following pages an attempt has been made to tabulate the
lesions as found in tuberculous cattle during the past two years, in order
that the reader may see ata glance the extent of the lesions, their loca-
tion, and the probable manner of infection. ;

The preponderance of air over food infection in the Washington herd
is well shown in Table I. In Table II the conditions are different.
Food infection played a prominent part in this herd, as shown by the
frequeney with which the throat and mesenteric glands were found
diseased,

In Table III air infection again predominates. In Tables IV and V
mainly advanced cases are given in which the primary foci of infection
are not definitely traceable.

The amount of disease in any given organ is indicated roughly by
the number of crosses, a single cross indicating slight infection. Dis-
ease of the retropharyngeal glands is not indicated in this way, a sin-
gle cross being used to indicate disease of the right or the left side.
Generalized or blood infection is indicated in the three last columns;
pearly disease in the columns headed peritoneum and pleura.

It should be noticed that in this list of 126 head of diseased cattle,
among which there were not less than 100 milk cows, one case with
tuberculous udder and three others with infected udder glands were
found.

*Vaginal discharges may contaminate the milk with other pathogenic bacteria unless
extreme cleanliness is observed.

9} suey,

-asvo on} Ayyenqoe st wey} zoySry yeyMouLos oq Avur poyorput o1oy WoToayuT pooy Jo oFuyueosed

Ha
OSMAN MIA HN
m4

“‘SSUNT ON JO asvostp 03 Arwpuodes us0q oAvY AVUT JOVI} OATYSOSIP OY} JO WOLJOIFUL Ol} TOT UI Sesvd OSoTy oYvaEdes 07 opvUT st ydu9}}v OU SOTqGLI OSOT]} UT x

“STISUO}
Re eSE Sta esocosesse|pqapecoeipeesscorieossccos| FACIAieaUMNsOat |) ae | ar 9
| |
o2e-------)----- Sacco) = tbe) =< de he Sa St ESI ic sasocsadoicoascoace alee eter ee + + sesce meee ee tee ew ele ee le =~ 9
“RImotUneud
Bye Maw eae qp eOSOC scQccloosenenBon|sotSesaes|aco5oqncad| dL or aeococeallposoasassol|sose550 500 oan nco Sala gon occljsoanpao ooo bam paaaoqanalacallanods POSE)
9
(oP) _L
SO SES SS earrings ease ites ape a4 nae
GLa en Nee yn eee eve seigneoneso Z
G
i
9
PRaS ewer an er Seals challeeeee ¢
BPRS ee eee eo Seale eta ¢
*‘pezl[Bilowos ATC
-eqord more, Uy diy! jesoesesose SDD oocGe jbo ok BSS ee S er orbDS tne eo||bOSmo cont at dl. fjoceae wee e eee ena =a |- ee -- @ .||PoeoRe anbogns e0¢
“Tyo rq
pue al Preee aOR SONA Ine ae [on oe | eee eee eae
physi oeecinns SIRE PSUORCOS RSS OR ES SNS Sapa ar te BAREIS | POUR aa rope seal Po ae ella aero Re (lo AGB |e COG
ES OAR AE By reenact Snes eae Datta Sea ee 2ESE ears Eon COA a Oran a ember cone Canty asst oee eee pees ig 10g
| a | oe. DG |e Me es
: =| FoR ae | ale
*(ouuTy | canele | T tcl
9ulOs 18 ; 9 Be : e ‘spurs :
p9}09) : year} “Spurts | .og | Onay SPUvo| peet Fo “‘spurpo
: 2 raeqnad ‘soposnur | PMT | -serpour |permouorg)| “oo \ - Px | teu | eee ecaod, qeaSTe spurps 13490, yeos SV “zaquun st
Seen Y[LUt) Jo LOTLOSOT smiey | -ogrreg: | | | -aAreyd
eet SLAG) , ; | -O11 0
Ieppu =
to orqud | "118 OY} Yonoiyy Worjod9zuy « pooy YSuo1y} ATqeqoaid woryoazuy

“(miqunjon £0 ,01.4ISUT) T Ploy wr suorsay

snopnaiagn, fo WONNgL.usig—'] AAV I,

140

onl

, *(@TUTy

| euLOS 4B

| poyoojUr

ATquqoad

| appt)
spurs
leppu

10 oIqud

“SY IBULAYT

“So[TosuUaL
jo |
Spuevy[r)

'
|
|
|
|

“ILv OY} TSnoaryy Apquqord worjoayay

|
|
|
|
|

*pooy [Snoiyy ATqeqoad wooasuy

8
G
§
Paro MeNES ¢
=i PAS a sea avi Cll Pere, Jsielesmuereei steieH (SS myetmiese mtip ra mien ie im) a||n) asim ee.=ai||=|B\s)S ig eas eee elem Sei ie. S95 Aaniel ps,
“ a) = 7 2 i j= }
=) | |
| | | | | ere, | |
eee alta | ‘spurps | | =a
> ry - | Jeg 2 Red ey ar 2 3 |
pm [eur SPUR cass | ann SpuLrs | 9110} prey jo spurs
eld. -SVIPOUL [VITOUO Be USTs) | ‘unemw | rT [eit0Od | 2. | spuvys ieqy3Q | Tees pay nar
| : * "s Q | -MOSO JX | | > aaV | Taq Un )
LOLLOSOg SUT ounrecr | MOSS NG | Bet PME an
| | | fier ha

‘ponuM0g—(miqunjog Jo JoL.4suT) J puay UL suoisa) snojnosagn) fo WoyNng.ysig—T AAV L

141

aft Soon con oer Ooo oo OaoneonooDomoncooG + -- fA lop acenonoodas ce9
SE a | Seaplane ee | op nee nl eeieteae Sao a meer eee eee lenreees 2 ced a ee Te oC Re R eC ee aao each é |* (J1eo 114) F£9
ST eae ellie eee cae | Scans oo erage sees geal ee creenral eale nee eal ee anneal eure aoa Aes reNellc aral | Quretel terion epee on 669
qe | Slates + | eSearimaanaeha ne Saas Eee e sre eee lee eee re 169
[eee aot Seas eis len hie area eae lege shee [Epes le Gaeta oS 089
+: apace wos cane area a eae ty JBL sl ears. mea 929
ae ale ey Pe cogaaes oe sae nee See Vistar (Urea lagers SC ar Goo
SI Beisel ces cto ae ageless Rc ety | ea scale ee ace egre ginpe S piee ere lg a a ak | eat [uGisies of f20 os taiscee gee £29
plein, + [> Kaeqprxvotqng |-----|-----| 7 BORSA 110)
ae aia | aoe ale ee ead ae ae | eee ees || Cae Sera |e perio [Caetano oe earl Me ee eE [Ift)
| |lsseccedall a ~ |oacogsscpocopoeaq|aoocansn|boavesvelpoosccaslousaiacsossoccpbos|ooes oleae a ee secre emeee 029
Ai areal dee ee se eae coe ec een ee Re eee a op ee rel er SS ase Gael eae Ties Macnee open aT Eee 619
JL + i i a i as I wm ee ee ee ee ee L119
ele ees area eee | eer te DELP S PaO neo Bose reaper anor aN gee OAD Se See [tes 19) SO SRO RRS =Gy (0)
t, locoasadd| ab = Hoeasoccdlbdconqsalococcesclleoscsdec|osasccgcoouendaneadssencaclsonacfooacs Zo «|eeneereeeece S19
fu fd eageeseslocconsoslocaseas|yesouemslocooucss|seqccocapanasecosa|ecoosfooca. Zo [ewer eceeeeeee 719
“Arey TxXeurqns
PA ZOSRSoRS|ocoom SAeOD seated ipo eos + [gga esse aa Resa c e SaaS | Siar otas © call nam coy norco ster tie casi sisi pa inaa srl Ie MOLE dig rone mat + |F BeOS OAC RO (0)
LOI SD eter reel ar ie awe ae a= oa aes | rao ap aP ar Par ie tay anata | ES ip eee PEN SOP SOSH Vit)
PO SO OI SOAS OS OAS OOM OOO ONOSOR) GOOG ooo + syonetee tonite + BOAT OE OOo + EONS + SESS highs aay eee hn a earn ea |e + P siacieieigean Sees B (}O)
Fe cheek email lace saeuc ae ak a ane ar ae eer A nth Raia RT gs en ne eae ca ieee Ment lerApe at one aire aay omer sey ea cece Te Ry at Gapanes O09)
S02 Soe ees Paredes isa sien ayes Sd ain Seen ae es se alisha acter fe arse Sp PRPS SS ONOMAST | ae PS =o Age eaaCO)
syddbagsce|tideeedoaguagoy feseele cee a + See peared agora aa ae eens ier GUS Es hnePecrebora ak peel 5 ZEDGE RBA AVA)
92 20992000[aabcosasneDSdose0s CoaoeuEE + Ue a BOCSeS So Btididarcto| PInoGCm noo dapolerodeas iiss lle -- KavypIxeurgqng i-----!-----| ¢ PORTER 2232202 qUAI)
(DRAGS) [poe ecosoec|>caccessosescscoosposoccadlasestoscte fo free ee eee |e renee ole e222 -|--- 2-2. al fo fee e eee eters eres -|-----|-- 2: ee Poe €6¢
“Wels) WOMAN joe FOF SF eR ae oss SS otRosooRod|seasuann aL ab a | oL +p fescereeseeee 6G
SSO PMO TO ITU eee saws aia ln Ste aaa nage Grier talline a apr eae BE ie Ceaser are oars io + ath POR arc cee Raa rene sige jecccc| po fees eee ees eee 16S
Spuvls [eu seh cemslte tisee ea epee are teats SPS uateiran |e ee ar Gly HEGESE ae ataae aT ane VARS eG cia (es ee eee ee cee 6g
wee ee ee ele eee ee ee - + -- ee ee i ee en Bik AIO lo gogiai Bete G Se Sitesi a aR
4 atte mslA ump asa tess ie aliges bres al Ste | ea Sa ara Stee ic 4 banner Acre eet =et5) laine" a epaa | a aee aletieteee e6¢
ate ar jag ee sy (ae ee ci ei erie ep Se aS oe Sa Re eo nSe BE) scsi || dpe pecan aaa G6G
eee tlie wats, Sligateaied ines rll sea our eg costae ean ae Ag tiiyso freee ey cae shee ecg SE clio ep | BIG anes mains acar 16¢
ats ale atte eee al fests + at steele |e Sige ar -Ureieny | etc ete ae ) Doe ety (sare ltl ure eter ake 06S
*poziyr ‘AIV][IXY YO SLL AV] |
-19M9.5 WOTJOOFUT |---------- -ndvoserd yysiy | ++ + ap San PS PROPS RG eae part pas ar ++ \---sivyrxeurqng ----- eee CTs cmesi le L8S
IS RDS GS ane aaa onan + ar taeaks |seguereecar pid reaching cates seas he hee geets ia gents ieee ere eee | SSeeey Gitaralccome an Tyme 98S
| -- : =| | | -—|
| | & | Hat | ea
| “spurl ee es
| <(omn | | ou “spurys | ‘spurs “SPur[s | “prot, “spurs |
| -9TU0S ‘BINT | -serpou | [ergo | ‘ssun’y | TOAT | aa0g | SeBTE JO SpULTS 10T9O, [vad |
i | 4% paqoo: iste) (4) LOLIO1SO Old | a : ‘tunel | Was eieae , y
syremeyy leap ane egacr oro eS 1109S0q 8010901 | oy aact | esac ony requin jy
spurts | ° | fe
orqud | — ol |. legit STE, 2 : eel aeel
af : 448 lec utarspart
oq} Ysnoryy A,qeqoad worjooyuy [TOON Nat! EsTMMOR aE) AN Tete (OL cone sien at |

“(YlOX MAN) TT pury fo woywod v ws suorsa) snopnowagn? fo woungr.usyug~— JT] AIAV],

142

asvastp
poziywr9uay

“WOTy
-BUIMIE AUT OAT}
-08 OU'STJ parva
-Tdod o1gvumnery,

|
|

‘pues
pl oF-9 00
euo pur
TOpTMoYS 0. 7,

i
vay ovay
+ ++ Set purl ocsyt| sakes apeanen
eee + eer hese |" yess asta |
tay a i oe Sra Htchatecsers [ae trae fenee al
weer ees se ate ep Sees ie eee ery
re eiee hae

++4+++

*SyIUIOI

‘SpuRpo

loappn
10

ATLAS

*sopOSnUL
jo spurry

"y 279 | |
sae | “spurs |
| [wrqo |‘ssun | "Taz
-Serpour | ne eles [reseceualE
IOTIO}S0q | : hay theese
q | site}! -oyt8g

RIDIT

ieintoe Staats (yu U1) T
veins ee ([[ Eur ut) A
en eiaisie (=i (rm ut) +5
Eee aB inchs ([Tu UL) oT

(17 Gurat ur you) of
uve Cran ay) ch
onriseeod (yyLu wr) Oo

(sprax ar) gf
(eu UL)
"AT Ploy

Ree (Y[LUL UT you) 'T

“777 SUTEU Ur you) yy
Ras fae 9 (ypu at) ¢

aparece (3[ [rat Wr) T
---*(3[TUI UT jou) FT
Rector -(yyLut ur) 4

Boks (SPU Wr)
OSES (Y[rUr ut) 7
eae She (xpytur ur) q
eam Silda Sophos (iq) O
2 “(Q[puu ar) g
27 Sar eC ROL LE) oy

DTT pier

ire ae Ts alee
‘spurs | roa “‘peoy eames
Bt 3 0 spurts 10y:
ey Se |aekOG) oe de “spurs |
[won ADIN

“ITB
oy} Yonorqy Apqeqord woyoayay |

|

-udsaeyd

| *poos oy} YSnoaqy ATquqord uorooyuy = “OTP

Ie)

“(ydOq nan) AT pww TTT spiay fo suoywod ur suorsay snopnosaqny fo uoyngr.ysyug— TIT ATAVL

143

‘(M019

-D9FUL pPoZITeIouoes)
wes{ds Url sepoxtoquiy,
‘BItouUNend o1eUNBLy,

*(MOTJOOJUL pozt[e
-1etes) SAoupry ‘voto
WI} JO s{soTMoToqmy, \----***<|\7-- 2220 --- 7 +4 +4 + | +++
*(sIsopnoreqny [eames
-uood ATqeqoid ‘poztpe
-1aues) Wes[ds Ut To0F
snojnoreqny ‘spurs “ploy
[EHS O SSIS OTMOTOUNT lee mene & -o0uy yor | ++ ++ a Par
"TOppN JO F[VY Fors Fo
SISO[NI1EGNI OATSMOIXT a aalleer eos ee ieeaccace 4 + aL.

*SpuLls “spurs
| (spars eNO) erpaur | HM /ssuny
: : -U01
*syIevUrOsT ae jo-uettery IOTIOISOg a
oTgnd
“Iv

oy YSnoryy ATqeqord wormoeyay

| “Arey
| -xvujsod qy0q
‘STISMTO} qjog | + | +
ies sjisuoy, | + | +
Oe e Soca see eee tae a
‘pues
orajed ATE] IEXVUL
[owe fe jpreecers f-+++} ++ | +++ | -3sod ‘sprsuoy, | -+ | +
“AIvT[Ixvuysod
Bao pe ++ ae t+ | +++ | ‘Aavyrxvurgug |j----7)-----
+ ee i ee i ie a a JP oecodoslpeocsosoossccagg90R9 + +
| oy
|. Spurs :
OAL ae EN | @ Gee cone
ssasenay | eee “TESOL 5 “spurs
+1! -oy110q jees
-uAreyqd |
| “pooz oy3 YSnoryy Ayqeqoad worjooyuy ADUUTSRSL

ANNA

“O58

(FI) &
~- QyTPer ar)

Bey-14@)

‘(nmbir4 ) A piay fo uonwod » w1 suo0rsa) snojpnowaqn, fo woungr44sig—' AT AIA,

s

144

“ermournoud . |
moryerdse ‘osussed
[esea Joroeysod oyte
surmedo ysnoryg Sut
-Sivqostp ‘esaey AoA _ | Aavyrxeurysod
[wosukreydomjer yyy jo -- 7c font (ipbeetege ag Ste as we ahs Stee Nia eee Noes pana ay age 4 Page Kea pure [Isuop yon 7 *--* ay “| AOTeS liga G63 ‘ON
“OnSST} :
9ATJOOUMOD UL SoRsoos | |
“CEOS TOUTED 14) GUISES ISG, ie el Ni a a el lea | We ae he a | Se | Wee ts piace lite + Actor the Koc llte, Sis ;
PADIS ded) WATE ESOS BE SECS CO ee irate een Tae | epee [pe eee aoe) oe ees steel let Staats ee le tee | 2 16a ‘ON
ara areas needa sab xkeaics a cll Ss Cc! Slants ain D1: S15 ah ae eae al heh Nea aa ae be ee te Ms allem | ede ed at emt (Nat ny |S eal tetas fe OSC a ay
(zg °d aag) |
ES] LULU EO’ CO TILIGMT, a |e es alla ane ae ae ne [esate arora. lees al| Sie ek ie mca as a ek ke a SE eho cine esl GRE [ESHOP TOT | table nealiecer sc Wises es £83 ‘ON.
* (Ory |
DeFUL poztyesrones) | |
sfoupry ‘weafds uiwog 77-777 eee ie +++} +++ seit eel Sasa | ars Siesteats ap See eet eS RAS UNS eae et S| fae ete oo 91Z ON
“MOLO9FUL GUTIEIN | | a8 Ae ;
SU e ms anUn ia auO e\iom nc co es coe fe Ooi psseme Dae hee leetene tality comes : yes allel Wa call te Sener es ene al SAup| “(89% *ON JO z
pue adso[ds ur soposzoqny, stents | f r+ TZ | FIR) 989g “ON
“pozt[eioues WoTjoayUr | |
‘spuevro [vuer pue eal
sXoupry ur pa LUN Toto tag AOU ES Reese le ec steeteate Seat Sp see Se Fal ome aa + Strate yt| ) orto) eae AP AS ESR ESET pele Goperel Rar aes 893 ‘ON
*Axoyd | | |
-ode quoramgaed yo por |-77777" sic smc sais so 'N5 fee aa | + sf 7 eee | SES eae cat Vea Ze ant fa aes ol Klee ae 7 tes ad arian Ss Fee tue | ee eee ee ee 99% ON
| | “puro
Sa Pe S| see mre ase bee ee ++ ++ Specter) irra canars | ae i eo stata oe cian ingrels aie | att BOT OUIN GTPPUAL |i sa cits saa loms al eae GCG ONG
I IPP
“SPULTs | |
} [Rou | |
-opLaod |
-O1JOL | bs
pus | | *AIBIL
1 na an Seenlesteatiate Wy gateats See | rear sehr eksy pies |S [pect PU ea cco. 862 ‘ON
Pee mel eacleas sete liz even pallies rales atl estore mire |b xeon ete [rocescce [tate es ce tene steer elena slice a elese ec e]e = 222-962 OKT
|
oe ‘ | | | pee ie Lge Vaal r a ij F
a) aia | | | s “n
| sets “spURls | ‘spueyd “spurs ‘peat eal gf
etecaleg “BING sSueaae | [eigo | ‘ssuny “IOATT | [eq0q OLIO} jo spurl zoo |
; Lae teppu *seposnul ; | -mo1g *snie}() “Uineu ; -Masa]q | * | ‘spuryz | -9Sy f
pee ee spurs | jo spurl) : [POMesRO ai | | SOUTIO | Peo raen fils ees eel eee Lae go ret
| o1lqnd ae ka Un a he F ; : -aArvyd
ayy ySnorqy A[qQvqord uoMoozuy | | *pooj 09 YSnoayqy ATquqoad woroeyay =| = -o0a30yy |
ea OA EE Ue z oS ee ee Sa Pena Ls peer Ne : shores 3 ee sie pets
"SplaY SNOUNA WOLL 8A8YI SNOBUN))AISU UL SWOISa? SNOpNILAQN) Jo UOYNGLYSIT—' A ATAV,
s

146

PLATE I.—Dorsal aspect of the bovine lungs. °

The lungs are laid so that the dorsal (or upper) surface is shown, The various
lobes are drawn apart so that their outlines may be distinctly seen. The lobes are
named in the text as follows:

a, m, right and left caudal lobes, respectively.

b, b,, right and left ventral lobes.

¢,c;, the two portions of the right cephalic lobes, denominated first and second
cephalic lobes.

(2, left cephalic lobe.

e, trachea.

xr, region most frequently involved in the earliest stages of pulmonary tubereulo-
sis. The lesions in this stage are, as a rule, embedded in the lung
tissue so as to remain invisible from the surface,

(2x) “SPNN] SNIAOG SHL 4O Loadgsy Ivsyoq

"| 3Lv1d ' , “Ansnpuy (euiijuy jo neeing ‘2 |Ng

Medial =, $i (or pore atmo

Bul 7, Bureau of Animal Industry. r PLATE |.

Zc ot Ne pk)
res Whe :
R ie Chiteea pecan ee %
“7 ae ~ t
~ J
~~ nd t % “ FR:
a =
&
N
:
.

PLate Il.—Ventral aspect of the bovine lungs.

The letters correspond to those on Plate 1.

ae

Pf a, am, right and left caudal lobes.

oe b, bi, right and left ventral lobes.

ae c, (4, first and second right cephalic lobes.
it £3 ¢2, left cephalic lobe.

d, azygos or median lobe (belonging to the right lung).

in the most advanced cases only. ;
e, trachea. :
wv, usual location of the earliest lesions of tuberculosis,

(§ x) ‘SONN7] ANIAOG SHL SO LOAdSW IWYLNSA

‘Al AaLV1d ‘AMsnpul [ewiuy jo neaing ‘7 ‘|ng

>

=

Bul, 7, Bureau of Animal Industry PvaTe Il,

VENTRAL ASPECT OF THE BOVINE Lunas. (x 3).

150

Puate II].—Trachea and bronchial tubes of the bovine lungs showing attached bronchial
glands.

a, a, air tubes supplying the right and left caudal lobes.
b, b,, air tubes supplying the right and left ventral lobes.
c, ¢, branches of the right supernumerary bronchus supplying the first and
second cephalic lobes of the right lung.
¢, air tube supplying the left cephalic lobe.
d, branch to azygos lobe.
é, trachea.
A, left bronchial lymph gland.
B, right tracheal lymph gland.
C, lymph gland at root of right supernumerary bronchus.
D, gland in the angle between bronchi; not always present.
The minute intra-pulmonary glands, situated along the main bronchi, are not
shown.

Bul. 7, Bureau of Animal Industry. PLATE III.

Mi,
YE, Mak}

y | ie 5 AN
Sf \ W
Wi ie
i ae
> Ah tars aN C’
f it 0) t Ne
Y !

iu

TRACHEA AND BRONCHIAL TUBES OF THE BOVINE LUNGS, SHOWING ATTACHED BRONCHIAL
GLANDS. (% #).

152

Pirate 1V.—Dorsal aspect of the bovine lungs showing the position of the posterior
mediastinal glands.

a, a, caudal lobes.

b, b;, ventral lobes.

C, C), C2, cephalic lobes.

e, trachea.

f, esophagus.

g, muscular pillars of the diaphragm.

h, posterior aorta cut through just beyond the arch and reflected so as to
uncover the left bronchial gland A, resting against the root of the left
bronchus.

i, caudal margin of the ligament of the lungs (ligamentum latum.)

The mediastinal glands are shown, most of them resting on the esophagus. The
aorta, fat, and pleural layers which inclose the posterior mediastinal space laterally,
are removed. :

a, the large caudal gland resting below the csophagus on the pillars of the dia-
phragm. This gland may be left in the body when the lungs and heart
are removed unless special care is taken.

The remaining mediastinal glands are arranged in two sets, on the right and
the left margin of the esophagus. In this animal there is but one gland
in the left chain. a is the gland most frequently diseased and in many
cases enormously enlarged.

a, the most cephalic of the mediastinal series.

(& X) ‘“SGNV15) IVWNILSVIGSIA) YOIYALSOd

ANY

AW 2227

34d “Asnpu| jeuiuy yo nesing ‘7 ‘jng

Bul. 7, Bureau of Animal Industry. PLATE IV.

POSTERIOR MEDIASTINAL GLANDS. (X 8).

154

PLATE V.—Section through the median plane of the head of a cow to show location of the
(left) retropharyngeal gland.
a, brain cavity. ¢
b, nasal septum.
c, lower jaw, sawn through.
d, tongue.
¢, posterior nasal passage.
J, trachea.
9, epiglottis, resting against soft palate.
h, esophagus.
A, left retropharyngeal gland, in this case enlarged to twice the normal size by
tuberculous deposits.

The opening into the left tonsil is shown as a dark spot under the soft palate,
The tonsil itself is situated beneath the mucous membrane, where the
cut surface of the palate appears and projects slightly above this, so as
to lie in part under the mucosa of the posterior nasal passage.

PLATE V.

‘MPH GLAND. (X }).

Bul. 7, Bureau of Animal

WSS
Ss . S :

RSS See 2s
SS See

Bul. 7, Bureau of Animal Industry
PLaTe V.

i) me
Hy B
==

SECTION THROUGH THE MEDIAN PLANE OF THE HEAD OF A Cow TO SHOW LOCATION OF (LEFT) RETROPHARYNGEAL LYMPH GLAND. (X14).

156

PLATE VI.—Right lateral aspect of posterior half of a steers head with skin and super-
ficial fat removed to show location of lymph glands. (x 3%.)

a, lower jaw.

hb, ear passage.

c, horn, sawn through near base.

d, styloid process of occipital bone.

e, parotid salivary gland. :

f, submaxillary salivary gland.

A, right parotid lymph gland, partly hidden under the anterior border of
the parotid salivary gland.

B, right post-maxillary lymph glands, the greater portion concealed beneath
the submaxillary salivary gland.

C, right submaxillary lymph glands between ramus of lower jaw and sub-
maxillary salivary gland.

(SF x) “SGNV1K) HdWA] JO NOILVOOT MOHS OL GVSH S:H3adLS V JO JIVH YOINSLSOd JO LOAdSY IVYsLV 7]

A aLv1d 2

‘Aujsnpul jewiuy jo neaing ‘7 ‘jng

Pate VI.

Bul, 7, Bureau of Animal Industry.

D)

=
&
a
a
z
s
(o)
x
a
=
i
we
5
z
Q
&
8
a
=
fe}
x
a
°
F
[oy
<
we
x=
2
a
w
w
=
)
Ome
we
°
wu
=)
<x
=
oe
o
c
=
D
foje
a
we
°
an
a
a

LETTER OF SUBMITTAL.

U. S. DEPARTMENT OF AGRICULTURE,
BUREAU OF ANIMAL INDUSTRY,
BIOCHEMIC LABORATORY,
Washington, D. C., July 1, 1894.
Srr: [herewith submit afew points of general interest with reference
to tuberculin, its composition, use, and effect on the milk when injected
into cows.
Respecttully,
HK. A. DE SCHWEINITZ,
Chemist of Bureau of Animal Industry.
Dr. D, E. SALMON,
Chief Bureau of Animal Industry.

TUBERCULIN AND ITS USE,

By E, A, DE SCHWEINITZ, PH, D.

As the use of tuberculin upon man proved more or less disappenrtiog,
due in a measure to its improper application, attention was turned to
its value as a diagnostic agent for tuberculosis in cattle.

The preliminary tests made in France and Germany showed that
tuberculin was a fairly reliable agent. This indicated that if properly
applied tuberculin might be useful in indirectly checking and controlling
consumption in man by paying due attention to its distribution among
animals, Accordingly, about three years ago, experiments in its man-
ufacture and use were begun in the Biochemic Laboratory in Wash-
ington. The preliminary and comparative tests with this and the
tuberculin manufactured in Europe proved the Bureau tuberculin to
be equally reliable, as will be seen from the accompanying report of
comparative tests made at the Wisconsin Station by Dr. Russell.

In order to attract attention to the prevalence of tuberculosis in
cattle, the resulting dangers to man, and the value of tuberculin in
controlling it, the Bureau of Animal Industry offered to supply the
boards of health and State experiment stations with this material,
to be used in diagnosing disease, provided reports were made of the
results obtained. The demand for the tuberculin increased very rap-
idly, requests coming from all parts of the United States, Canada, and
the West Indies,

During the six months, beginning January 1, 1894, there has been
manufactured and distributed from the Biochemic Laboratory of the
Bureau, tuberculin sufficient for about 4,600injections, which, at the
price charged in New York for Koch’s tuberculin, would have cost
about $3,500, This does not include the tuberculin used by the Bureau
for testing some special herds, which would be about 300 injections
more. The Bureau has also been supplying mallein for the diagnosis
of glanders, the use of which has proved exceedingly valuable. This
will be referred to in detail in another bulletin.

The tuberculin prepared by the Bureau is always tested on tubercu-
lous cattle in order to have, as far as possible, a uniform material, so
that results from different localities can be satisfactorily compared.

159

160

Reports of the results of the injection and post-mortem notes have
been received from a number of different parties, the largest number
from the experiment station of Vermont and board of health of Massa-
chusetts. In all cases where the animals showed a characteristic reac-
tion and were killed, the autopsy proved the presence of tuberculosis.

The report made by Dr. Russell upon the comparative value of the
Bureau and Koch tuberculin, the results of which are appended in
Tables VIJ and VIII, was as follows:

The number of animals selected for the test was 18, mostly high-grade stock. The
herd was divided into two equal parts and the one lot injected with the Bureau tub-
erculin, the other with the imported article. After four to seven weeks the injee-
tions were repeated, the order of procedure being changed. Those that had received
the imported product were given the Bureau tuberculin and those that had received
the Bureau tuberculin were given the imported product.

Out of a possible 15 cases, as two animals of the herd did not react with either
injection and were not slaughtered and one animal was excluded by an accident in
the experiment, the Bureau tuberculin gave 14 correct diagnoses. In one case
(Beauty), neither the Bureau nor the imported tuberculin showed a reaction, though
autopsy proved the presence of tuberculous lesions. In 4 cases, Gay, Aggie,Galena,
and Daisy, the second injection with the imported tuberculin failed to show a reaction.
though the first injection with the Bureau tuberculin had shown’‘a marked reaction,
which was confirmed by the autopsy. This lack of reaction from the Koch tuberculin
may have been due to the fact that the amount of tuberculin was not asstrong as that
used on the first injection, though in two similar cases, Polly and Melvina, the same
quantity of Koch tuberculin showed a good reaction upon the second injection,
after a marked reaction had been shown by the first injection with Bureau tubercu-
lin. ‘These tests have shown again the entire reliability of the Bureau tuberculin.

By some a decided local reaction has been noted at the point of inoc-
ulation of tuberculin. Dr. Russell reports that where vare was used
in sterilizing the syringe no irritation resulted. Unless such precau-
tions are observed, therefore, any local reaction is to be attributed, not
to tuberculin, but to septic infection.

In a great many instances the disease is found to be but slightly
advanced in a number of animals, so that the milk from such animals
would not necessarily be injurious. This, however, could be proven
only by careful examination and inoculation experiments. .

That tuberculin has some curative properties is undoubtedly proved
and these might be utilized to advantage in many instances. In Marcel
two tuberculous cows were brought to the station for experiment. In
one the disease had been diagnosed by Dr. Schroeder upon physical
examination and both had responded to the tuberculin test. One of
these, No. 286, was with calf at the time, which she subsequently
dropped and it was to all appearances in perfect health.

The milk from this cow used for the inoculation of guinea pigs by
Dr. Schroeder caused the death of a number of the animals, but not
from tuberculosis. No tubercle bacilli could be detected by centrifu-
galizing and subsequent microscopical examination of the milk. The
calf was kept for several months, all the time with the mother, and

161

had all the milk. After two months she received an injection of 0.75 ce.
tuberculin, but failed to show any reaction. The mother showed a
reaction upon the first and a slight reaction upon the second injection,
a marked reaction upon the third, and upon subsequent injections
a slight reaction. On the contrary, No. 285, which had shown a
high reaction upon the first injection, gave but a slight reaction on
the second, and subsequent thereto no reaction at all, as can be seen
from the Tables I and V. The animal was thrifty and apparently
in fairly good health and had improved since brought to the station.
It will receive more injections of tuberculin, but has to all appearances
been benefited by the action of the tuberculin.

Now, as to the nature of the active principle of tuberculin, the inves-
tigations of Kiihne, especially, have shown that as ordinarily prepared,
the culture fluid contains so much peptone, with which there is always
more or less albumose, that it is impossible to separate the true prod-
ucts of the bacillus from the other substances present in the culture
media. The simplest way to avoid this difficulty, which was also
encountered by the writer, is by the use of fluid for the cultivation of
the bacillus in which glycerin, mineral salts, and asparagin or urea
were the food for the germs.

I have used two formulas, both of which have given fairly satistac-
tory results in regard to growth:

1. Water, 1,000 cc. Sid 2. Water, 1,000 cc.
Glycerin, 70 grams. Glycerin, 70 grams.
Acid pot. phosphate, 1.0 gram. Sodium chloride, 6 grams.
Am. phosphate, 10 grams. Calcium chloride, 0.1 gram.
Sodium chloride, 10 gram. Mag. sulphate, 0.3 gram.
Asparagin, 2 grams. Ac. pot. phos., 2.5 grams.
Mag. sulphate, 0.2 gram. Am. lactate, 6.5 grains.

Asparagin,. 3 grams.

After sterilization of the ripe artificial cultures, the germs were
removed by filtration and the mineral salts by dialysis. The addition
of absolute alcohol to the dialysed solution, free from mineral salts,
produced a white floceulent precipitate. After drying in vacuo over
sulphurie acid this was difficultly soluble in water, swelling up, par-
tially soluble in dilute NaOH, insoluble in salt solution. Its water solu-
tion yielded a slight opalescence with nitric and acetic acid, and a pre-
cipitate with ammonium sulphate. The substance gave the biuret
reaction as well as the xanthoproteic, but did not respond to Millon’s
test. It was free from ash, did not contain sulphur, but phosphorus,
the latter combined in the molecule, as: it was evident after boiling the
substance with nitrie acid.

The precipitate, therefore, would seem to belong to the class of the
nucleo-albumins.

As there had not been a particle of albuininoid matter in the solution
this was a purely synthetical product of the germ life.

2891—No, 7 1]

162

The reaction of this nucleo-albumin was tested on a tuberculous
guinea pig; 0.002 gram dissolved in water caused within six hours a
rise of temperature from 102.6° to 104° F.

The solution of the substance that passed thr ough the dialyser con-
tained at first only the mineral salts and some glycerin. After two
days some of the albumin had passed through the membrane. The
solution free from albumin failed to give any alkaloidal reactions, and
produced no rise of temperature in tuberculous guinea pigs. Aspara-
gin, as such, appeared to be no longer present in the solution, and the
mineral phosphoric acid and nitrogen had become incorporated in the
organic molecule. This is but a brief notice of a study of the active
principle of tuberculin as, prepared from artificial cultures, and is
being pushed as rapidly as the difficulty and nature of the work will
allow.

The danger of injecting tuberculin in healthy animals in moderate
quantity is slight. In healthy guinea pigs I have found that an injec-
tion of a dose twenty times as large as that required to produce a
reaction in a diseased cow may kill, but will not always do so. There
is no danger of infection if the tuberculin is properly prepared.

In order to see the effect, if any, in introducing tuberculin into the
stomach we have fed tuberculous guinea pigs varying quantities of
tuberculin. A dose of 0.5 cc. diluted tuberculin which, when injected,
will produce a rise of temperature 2.5° to 3° F'., when fed to another
pig in thesame stage of the disease is without effect. If the dose be
made twelve times as great there is a slight rise of temperature in
four to six hours. Repeated daily feeding of small doses of tuberculin,
2.5 e¢c., will cause a slight rise of temperature after the fourth day in
tuberculous pigs, showing its action to be cumulative. Upon healthy
pigs the larger dose is without effect. Such a quantity is entirely out
of proportion to that which man or animals could get under any ordi-
nary conditions, and from the appearance of the stomach in the guinea
pigs the rise of temperature is due to the irritation rather than as dis-
semination of the tuberculin through the system.

Although the active principle of tuberculin is very resistant to the
action of artificial digestion in a 0.2 per cent pepsin and 1 per cent
hydrochloride acid solution, under the action of the different ferments
and acids of the stomach it would probably be more rapidly decomposed.
In the case of invalids and children there might be some irritating and
poisonous action resulting from tuberculin.

Dr. Schutz* claims that the effect of tuberculin injection does not
change the specific gravity of the milk.

We have made a few examinations of the milk from healthy and
tuberculous cows taken the day before injection, the day of injection,

*Arbeiten aus dem Kaiserlichen Gesundheitsamte, 1892, p. 40, Vol. x111.

163

when the temperature was about at the maximum, and the day or two
after injection as shown in the tables. Nos. 113 and 217 were healthy
animals; Nos. 285, 286, 110, 290, tuberculous. Through an error on the
part of an assistant the samples brought for analysis were, in Table IT,
the first portion of each milking, except in case of Nos. 286 and 113,
where the entire amount was saved. The error was not discovered
until too late to make the corrections with these animals, but the
results are comparative.

In the results noted in the other tables the analyses were made from
the entire milking. Cows Nos. 285, 286, 217, and 113 were ordinary
animals. No. 290 wasa Jersey. In this work I have been ably assisted by
Mr. J. A. Emery, who has made a large proportion of the milk analyses.

The Tables IV and VI show that the acidity of the milk from the
tuberculous cows was less than that from the healthy, and the amount
of volatile fatty acids was decidedly less. This can not be attributed
to the breed of the animal, as No. 290, a Jersey, shows almost as low as
No. 285. The figures for volatile fatty acid are calculated on the num-
ber of cubic centimeters of n/10 Ba(OH), solution required for the
neutralization of the volatile acids from 1 gram of fat of each sample.
Table VI shows the average daily variation in the milk of the animals
Nos. 285, 217, and 290 under normal conditions, while Tables II, III,
and IV show the changes in the milk constituents under the action of
the tuberculin.

In Tables I and V are given the temperatures of the individual ani-
mals during the tests with tuberculin on the dates corresponding to
those upon which the milk was collected for analysis.

In general, the results show a decrease in total solids in the tuber-
culous animals after the injection. In the healthy animals there is also
a Slight decrease in solids but not as much as in the diseased animals.

There is also a decided variation in the proportion of fat before and
after injection of the tuberculin as well as albuminoidsand sugar. The
fat and sugar decrease, the albuminoids show a slight increase. The
_ latter may, in part, be attributed to the presence of a small amount of
tuberculin in the milk. This variation in the constituents of the milk
would indicate that, while under examination with tuberculin, the milk
of the animals should either not be used at all, or close attention paid
to the fact that tuberculin will cause such variations. These results
are but preliminary to a more extended examination. ;

As the inspection of tuberculous animals continues, more careful
examinations will be made of the milk, and other interesting questions
relative to tuberculin and its effects will be studied.

164

RELATION BETWEEN THE TIME AFTER INOCULATION AND THE
REACTION WITH TUBERCULIN.

In order, if possible, to arrive at some idea as to the length of time
after inoculation with tuberculosis before an injection with tuberculin
would show a reaction, the following experiments were begun some
time ago. These wereinterrupted but are being continued again. The
result obtained with the first two sets of experiments may be recorded
here, and will be found in Tables IX and X. Guinea pigs, about 1
pound in weight each, Nos. 421, 424, 425, 426, 429, and 430, were inoc-
wated with tuberculosis from an emulsion of the surface growth of an
agar culture in 10 ¢.¢. P.b. b. on July 10, 18938. Nos. 427, 428, 431, 432,
433, 435, and 436 were reserved as checks.

The first injection was made July 13 with 0.25 ¢.c. tuberculin on No.
429, and arise of temperature in three hours of 3.2° IF’. was noted. The
animal showed at the point of inoculation with the germ a slight swell-
ing, otherwise was apparently in good health. July 20, the injection
upon No, 429 was repeated, 0.125 ¢. c. tuberculin being used, and Nos,
430 and 428 were alsoused. The check showed no rise of temperature,
while the inoculated ones showed a rise of about 1° T.each. This was
ten days after the inoculation. July 21 and July 26 the injection was
repeated on Nos. 429 and 450, respectively, with a rise of 1° F., but
the checks still showed no reaction.

Nos. 425 and 426 on July 22, both of which liad been inoculated on
July 10 with the same amount of a culture of tuberculosis gave, when
injected with tuberculin, a rise of 1.6° and 0.6° I., while the cheek
showed a fall of temperature.

Tested again on July 29 both pigs showed about the same rise in tem-
perature as before.

Nos. 424 and 425 when first tested showed about the same reaction
as the others, the same number of days after injection, as did also No.
421, six days after the injection. No, 424 died from general tubereculo-
sis on August 12, just two months after the inoculation. As it seemed
from these injections that the tuberculin produced a reaction almost as
soon as the germ was introduced into the system and before any local
lesion, other than the inflammation set up at the point of inoculation
could be formed, the experiment was repeated with results as recorded
in Table X,

ior this experiment pigs Nos. 482, 485, 485, and 486 were inoculated,
and Nos. 481, 484, 487, and 488 retained as checks. They were inocu-
lated October 7, 1893. October 26, pig No. 482, which had on October
25 shown a reaction with tubereulin, was chloroformed and examined.
There were a few small tubercles in the lungs, otherwise the animal
was apparently healthy. Five days after the inoculation the pigs
showed a slight reaction; ten days after, no reaction; eighteen days
after, no reaction. The first injection of tuberculin probably interfered
with the others, and also retarded the advance of the disease,

165

No. 486 received the first injection of tuberculin eleven days after
inoculation, but showed no reaction. When tested again, twenty-four
days after, there was a rise of temperature of 1° only. Four months
afterwards the pig was found dead, and although there were a tew
tubereles in lungs and liver, and the glands of the knee near the point .
of inoculation were tuberculous, the animal had died from other causes.

In the case of No. 483, the first injection, seven days after the inocu-
lation, as well as the subsequent ones, eleven and twenty-four days
after, showed a reaction of 1°. The pig was chloroformed on Novem-
ber 5, just one month after inoculation, but beyond a very slight swell-
ing at the point of inoculation there was no sign of lesions. The injec-
tion with tuberculin had probably checked the disease. In the case of
No. 485, the first injection with tuberculin showed arise of 0.4° F. nine
days after inoculation. The second, eighteen days after, a rise of 0.6°
F.,and one month after, a rise of 2°, The pig was found dead on
December 8, two months after the inoculation. The glands at the
knee-fold were enlarged and tuberculous, the lungs were hemorrhagic
and contained a few tubercles; liver and spleen normal.

In two instances the checks gave a slight reaction upon the first
injection with tuberculin, but when chloroformed immediately and
examined seemed healthy, and their temperature before inoculation
had been a little high.

Two guinea pigs that had been inoculated with tuberculosis on July
10 received an injection of tuberculin again on November 8, and showed
a marked rise of temperature. They were both found dead a month
Jater, and autopsy showed ulceration where inoculated, liver enlarged
and fatty, lungs covered with tubercles.

These experiments tend to show that the reaction in temperature may
be influenced by the location of the lesions. So far, however, in the
examination of tuberculous cattle it has been impossible to show any
fixed relationship between the character and extent of the tubercular
lesion and the amount of reaction.

To see what lesions would be produced by infecting guinea-pigs with
feeding them tubercle cultures, 5 pigs were selected, and on May 24, 1894,
fed 0.5 and 1 ¢. ¢., respectively, of liquid tubercle culture. On June 22,
1894, 1 of these pigs was chloroformed. To outward appearances
the animal was healthy. The autopsy showed the lungs to be congested
and covered with a large number of incipient tubercles. The liver was
soft and friable, and the spleen pale and covered with a number of
tubercles. The stomach and intestines did not show any signs of
tuberculosis. .

On July 10 another one of this set of pigs was chloroformed. Autopsy
showed about the same condition as the first one, viz, incipient tuber-
culosis in the sple.n and lungs, but the other organs were apparently
normal.

166

The 3 other pigs of this set were to all appearances perfectly heats
though they all had a high temperature, viz, 103.59-104° F.

In the case of glanders Nocard has found that if the virus is intro-
duced into the stomach with the food of the animal the disease will
develop rapidly, but the lesions will be found in the lungs and spleen,
with no sign of disease in the stomach. The tests on guinea pigs would
point to the possibility of a similar action in the case of the tubercle
bacillus when taken in through the alimentary tract.

TABLE I.— Temperature reactions of cows on repeated injections of tuberculin.

Fea, cows Secon
| OR Ey | cows Nos.—
| Date. | Time. ie Date. Time:*>:|—saenmee
eerkanper semesters orice 4 Movie meemaemoe ff
| | Temperature. ) Temperature.
1894, | | 1894, |
Mar. 30 | 6a.m..... { 101.2; 101.5 || Mar. 19 | lla.m.-.-.| 102.3 102. 2
Mar. 30 | 8a.m..--. 101.7 | 102.3 Mar. 19} lp.m.-...| 102.0 102. 2
Mar. 30 | 10 a.m 101.8 | 102.2 || Mar. 19 | 3p.m---.| 102.0 102. 2
Mar. 30 | 12m...... 99.0 | 100.7 | Mar. 19) 5p.m....| 101.0] 101.5
air opal Jo decee Mar. 30 | 2p.m..... 100.7 | 101.4 |} Mar. 19 | 7p.m....| 101.7 101.7
Day hefore injection. 4| yar. 3 | sdiprans Ser 100.8, 102.0 |) Mar. 19! 9p.in.-..! 101.0] 101.8
Mar. 30 | 6p.m.....| 101.0} 102.5 ||
Mar. 30 | 8p.m..-.-. 100.8 | 101.7
Mar. 30 | 10p.m-...., 100.5 101.0 | |
{| Mar. 31 | 6a.m-..... | 100.5 101.4 |
Injected 2 ce. tuberculin at 7 a.m. Injected 2 cc. tubereulin at 11 p.m.
Mar. 31 10a.m.-...| 101.7 | 102.8 | Mar. 20 | 6a.m..... 101.0} 101.2
Mar. 31! 12m....-.. 101. 4 | 101.4 | Mar. 20} 8a.m..... 101.4 101. 0
Mare Sis Jip.) =e ioe 101.0! 101.8 |) Mar. 20 | 10a.m.-.-.} 101.2 101. ,
Mar. 31 | 4p.m..... 101.5 | 102.5 || Mar. 20 | 12m.--..-.- 101.2 101. ;
Mar. 31 | 6p.m...-- 101.5} 103.0 || Mar. 20} 2p.m-....| 103.2 101. 4
| Mar. 31 8p.m..... 100.0 | 100.7 | Mar. 20 4p.m.-..| 108.5] 102.0
Mar. 31 10 p.m.-..| 100.4 101.4 | Mar. 6p.m....| 103.2 101. 6
ADI 4d Sape mle. eer. 100.8 | 101.4 || Mar. 50 8 p.m 103. 2 103. 0
|| Mar. 20 | ie m ...| 101.6 103.
|| Mar. 20/12p.m...| 100.8] 102.6
‘ Tuberculin—
Day when injected... | | preave cted at Ba i
| | 2 as aaa ie ar aed | 6 ce. | 4ce.
| ij - | a
| | | Mar. 21 | 7a.m...-.| 101.2] 102.3
| Mar. 21] 9a.m.....| 101.8] 103.0
| Mar. %1 | lla.m.-..; 101.0 102.8
Mar. 21|1p.m.....| 101.4] 102.5
| | Mar. 21 | 3p.m..... | 101.2 102.4
Mar. 21 | 5p.m..... | 101.2 102.0
Mar. 21 | 7p.m:-.-. | 102.0 103. 0
| Mar. 21 | 9p.m..-.. | 101.4] 103.4
Mar. 21} 1lp.m....) 101.0 102.4
|| Mar. 22 | 7a.m..... 101.0 101.0

* Milk collected March 31 and ‘Act lat 7 a.m.

167

TABLE I.— Temperature reactions of cots on repeated injections of tuberculin—Cont’d.

Sec- | = Anda |

- | Third injec- |
ond in tion tubercu- | Tuberculous
rs ealthy lous cows | | cows Nos.—

oe ees 4N OS. — |
| Date. No ee eee Daten: |e. Sime? Saphapiearan SS
217.f | 285.t | 286.4 110.¢ | 290.t
Temperature. | Temperature.

| 1894. | | 1894. |
(| Apr. 12 --| 97.2 | 98.8 | 101.2; Apr. 16) 2p.m-..-| 100.5 }.......
| Apr. 12 | 98.7 100.0 | 101.8) Apr. 16 5p.m... 99.8 |.......
Apr. 12 | 101.6 | 100.5 | 102.8 | Apr. 17 6a.m-.- 100.8 }.......
Apr. 12 101.2 | 101.0 | 102.8 | Apr. 17) 8a.m-~.-.. 100.4 |.......
Ses Pa cere i Apr. 17 | 10a.m_-.} 101.4 |.....-.
Day betore injection. | | Apr. 17, 12m..-.| 100.5 | 101.0
Apr. 17 2p.m..-) 99.5! 102.0
} Apr. 17 | 4p.m 99.7} 101.8
| Apr. 17 | 6p:m--.| 101.5 | 102.8
(| | Apr. 17 | 8p.m..., 101.0 | 101.5
| | |

Injected 2 ce. tuberculin at 11 p.m.

Inj ected 2cc.tuberculinat11:30p.m

(| Apr.
|) Apr.
Apr.
Apr.
Apr.
\| Apr.
Apr.
Apr.
1
|

Day when injected...

DORIS HH 00
ST's

+ Milk collected at 5 p.m.

if

101.4 | 101.0 |
102.2 | 101.4
101.2 | 102.0
----| 102.0 | 101.0

.--} 101.2 | 101.8

---| 101.2 | 101.7
101.4 |; 102.4
101.2 | 101.8

103.4 | Apr.
103.2 | Apr.
104.2 | Apr.
104.5 | Apr.
105.0 | Apr.
105.2 | Apr.
103.0 | Apr.
102.6 | Apr.

| Apr.

| Apr. |

18 6a.m...| 101.2) 102.5
18 8a.m...| 101.0) 103.0
18 109.m-..| 103.8 | 104.3
18 | 12m....} 105.8} 105.0
18 | 2p.m--.| 104.7 | 105.0
18 | 4p.m-.-..| 105.7 | 105.4
18 | 6p.m 105.4 | 104.6
18 | 8p.m-...| 104.0} 104.6
18 | 11:30p.m| 101.4 | 105.0
19 | 7a.m-.-| 100.0 102.8

TABLE I1.— Percentage variation in the constituents of the milk from healthy and diseased
cows produced by the injection of tuberculin.

Mar. 19| 14.48] 3.33
20] 10.32| 3.12| 3
21] 12.43] 3.12
92} 11.25] 2.72 |

Sugar.| mi-

ou

Mar. 19 15.44 2.72

Mars Sie Ol 124.17
Apr. 1| 10.69, 3.84 |
|

ia

NO. 285.
Ash (in Ashi Gn)
Fs | tota!
Ee | solids).
669 | 4.61 |
.692 6.71
732 | 5. 88
_ 802 | 718
NO. 286
661 4.28
TD BaD
724) 4.7
769 «5.70

NO. 113.
TTL |= 1.08

Chio- | Chio- | Chle-
rine (in| rine (total
| milk). | (ash). solida).

. 010 | 1.55 O77
. 010 1.47 . 098
. 0046 . 632 . 037
. 016 2.09 - 149
O1L 1.69 . 066
| |

005 | .786| .041

- 0049 | . 681 . 032

015 2. 04 114

023 | 3.03 , 213
041 6.57 ,429

Remarks.

Before injection
(injected llp.m.,
tuberculous.)

After injection.

Reinjected (12:15
a.m.).

After reinjection.

Before injection
(injected 11 p.m.,
tuberculous).

| After injection.
| Reinjected (12:15

a.m.).
After reinjection.

Before injection
(healthy).
After injection,

168

apie I1.--Percentage variation-in the constituents of the milk from healthy and diseased
cows produced by the injection of tuberculin—Continued.,
NO. 217.

Albu.

ye 2 Chio. |
aah yo, 2. Ash (in Chilo- — Chlo- re
Date. ca Sugar. mi- Fat. ee total rine (in rine (total | Remarks.
Sons noids. * ‘solids). milk). (ash). solide
Mar. 31 10. 83 4.17 2.96. 2.23 . 123 6. 67 . 0023 > 325 0216 | Before injection
; (healthy).
Apr. 1 10.38 4.16 92.89 2.54 . 730 6. 81 OTe). eo .255 After injection.
NO. 286.
Apr. 12 | 16.24 1. 92 2.44 | (*) . 822 RUE eee Sp eeeer Siserne Si, Before injection
| (tuberculous).
13.) 12.62} 1.56 2.72 (*) - , 720 5. 70 . O43 6.01 | .343 After injection.

‘Quantity of milk insufticient for a determination.

NO. 110.

Apr. 17 | 12.59 3. 84 3.23 5.14 672 5.33. 050 7.54 -402° Before injection
(tuberculous).
18 12. 58 3. 84 3.20 |; 4.12 . 750 5.96 .061 8.17 . 487 After injection.
19} 10.52 3.84} 3.19 3.08 . 666 6.53 |. . 036 8.10 .530 | Second day after
| | injection.
NO. 290.
Apr. 17. 13.62 3. 84 3.48 | 5.65 . 684 5. 04} 21052 7.70 . 388 | Before injection
(tuberculous).
18 15.31 3.57 3.25 | 7.23 . 786 5.13 |. .089 | 11.43 .587 | After injection.
19 11. 23 3. 57 3.42 | 3.08 . 667 5. 66 . O51 1.0 - 437 Second day after
injection.
NO. 217
Apr. 12. 11.03 4.17 1.26 | 2.56 681 6.17 054 8. 05 .497 Before injec tion
(healthy).
13 9.77 3.57 1.39 | 1.53 . 727 7.44 060 8.35

. 621 After injection.

TABLE ITI.—Vercentage variation in the constituents of the milk from healthy and diseased
Y . . . = .
cows produced by the injection of tuberculin.

NO. 286.

Specitic Total Ash (Ash(total Albn-

Date. gravity. | solids. (milk). solids). | minoids. Sugar. Fat. Remarks.
May 15.. 1. 031 10. 52 (i 6.75 2. 89 3. 84 3.05 Before injection of tuber-
eulin.
16_. 1. 029 11.13 a (il 6,39 2. 81 3. 84 3.57 | Do.
| After injection of tuber-
Vee 1. 029 10. 83 . 728 6. 93 ve | 4.16 2.55 eulin.
NO. 285.
May 16.. 1: 023 17. 01 . 761 4.47 4.35 2.77 10.27 | Before injection of tuber-
eulin. .
ire 1. 027 14. 27 718 5. 23 4.01 3.12 ' 6.03 | After injection of tuber-

| culin.

Increase after injection in sugar, ash, and specific gravity.
Decrease after injection in fat, albuminoids. and total solids.

169

\
d TABLE IV.—Percentage variation in the constituents of the milk from healthy and diseased
cows produced by the injection of tuberculin.
NO. 285.
| } | No. ¢e | No. ce
! {
- : Acidity, n _ » Ra(OH).
Date. | Total Sugar. Albu war. ASH dactic 19 NHsOH | ipa De |
solids. 2 Toinoids (milk).) <5. | : | for volatile |
acid reyuired for | 21 weed
Teesmilik | fat acids in |
é "| one gram fat. |
Meayeslal lit sdapessod p30. 41 4) 8.95) 3672 2... 23s). 5- 52 ek ace | 3.48 Before injection.
» Tune L-.(14.60-) 3.571 2.80 6.13) .668 '.:....2.|...-.0----220. | 4.85 Do.
: 5117.77} 2.77; 2.88 10.25 . .620 084 | 094 | 4.00 | After injection.
NO. 286 f
y ee ee sass ee sie
} | |
May 31-..) 10.41 | BEGG Ste he 20 OP los See. Cs elas nr 9.34 | Before injection.
June 1..| 10.17 | 5. 00 1ROZ Ee Opn er OLOM ee cece [omisseror era ins 11. 68 Do.
5-..| 10.44 | 4.16; 1.04] 2.55) 5556) .12£ | - 138 12.15 After injection.
NO. 217.
Mislee eI 2e03 ede lGnhy moS2ni 254 3h eis See eee eee ees 10.04 | Before injection.
June 1..! 10.25 , 4.16 CBr S (onl afall se RSE ea ass Paeeeaaeaca se 15.74 | Do.
5.. 11.26 4.16 2.70. 2.03; .688 .176 - 196 16.45 | After injection.
NO, 230.
ae = i ero aint
May 31..| 15.57! 3.33] 3.26| 7.66 | -622)........ esters anes 2 5.09 | Before injection.
June 1-..| 14.96 | 3.85 | 2.70 USM ithe OU Be rere ses oleate erech aera ets 4.99 Do.
3. | 15.87 | 3.33, 3.381 3.19) .549 - 097 - 108 5.93 | After injection.
TABLE V.—Temperature reaction of cots on repeated injections with tuberculin.
| Fourth injection. Fifth injection,
| tuberculous tuberculous Third injection—
| cows Nos. — cows Nos. —
Date. I T oe SS auperen ae
Time. Date. Time. :
he 285. | 286. Pe te 285. 286. lous cow |, Healthy _
INOS 25055 fy aid aes
J } — = — = — =- = a = —— —
| Temperature. Temperature. Temperature.
May 16. | 7a.m..... 100.4' 99.6 May 31.., 6a.m-..-..-| 100.7 100.2 | 101.0 100. 2
Oekimies ke 99.4 | 100. 2 [Siae misao | 100.2.' 100.0 100.5 100. 0
lla.m 100.8 | 10u. 6 10a.m....; 101.5 101.2 101.0 101.2
¥ lp.m..... | 101.0 100.6 12m...... 101.2) 100.2 101.0 | 100.8
3p.m-..-..) 100.0 101.0 Bib WN. dese 101.2 101.8 101.5 | 101.4
5p.m..... | 101.4 101.5 4p.m..... 101.2 101.0 100-4 | 100.7
7 p.-m...-- | 101.0, 101.4 6p.m..:.-. 101.7 101.6 102. 0 102. 0
| 10 p.m 101.0 101.0 8 p.m..--. 101.8 102. 6 102.4 102. 2
pujocted 2c0. oe Fe | Injected 2ce tuberculin.
62 3 ae | =. os
May17._ 7 a.m... 100.8 | 100.2 | Junel..| 6a.m..... 101.5 | 100.4 | 102. 6 | 100. 7
Io fascrin ene 101.0 100.6! '8a.m..... 101.2 100.5 | 103.0 | 101.5
Ii a. m=: =; 101.4 100.8 | | 10a.m 102.4 | 102.4 | 105. 0 101.4
1lp.m..--- 101.7 = 101.0 | D2 = s. a = 103.2. 102.0 105.6 101.8
3p.Mm..--.. 101.0 101.6 PAR 0p 1 eee 102.4. 102.4 | 105. 6 101.0
| 5p-m..... 101.2 102.2 jae. 103.7 102.8 | 105. 0 102. 2
ispinnia sss - 101.8 103.5 | 6p.m....., 102.5 103.2 | 104.0 101.7
| 9p.m-.--- 101.8 102.6 SppaiMieces: 101.8 102.4 103. 2 101.8

170

TABLE V.—Temperature reaction of cows on repeated injections with tuberculin—Cont’d.

| Sixth injection.
tuberculous cows
| aie Calf. of
| re 226,"
3 Date. | Time, 285. 286.
Temperature. 2 je =
aa Leena ee eee ~ | ae aes aa
SG Se Sos ee San ee eee ea a ee 101.0 100.5 | » 2S pees
: | Dragana 101.6 | 100.7 | 102.0
|} Jla.m....| ~ 102.8 103. 2 | 101.6
jk Pst e ee 102. 6 102. 2 | 102.4
cag Da eb eit 103.0 | 102.7 102.8
| 5p.m.....| 102.8} 102.4 | 103.2
7 psMe=2=- 103. 2 | 103. 8 102. 6
| 9p.m_._.. 102.0 102.7 103. 8
| |
: Tuberculin.
| Injected | iy
; at 9 p.in. ee Zee.
MI Gree see aes tee See ee aa SURE Fe ta ae aM cael 101. 4 100. 8 101.8
Facms ss. / -101. 4 100. 6 101.2
lla.m | 103.0 | 103.0 101.8
Lpomhe as 102.6 101. 6 102. 0
opens | 103.0 102. 6 102.8
dp.m..--. 101.5 | 101.8 103.0
fies eae kee 101.7 | 101.6 103.4

* Two months old.

TABLE VI.—Normal daily percentage variations in the constituents of milk from diseased

and healthy cows.

NO. 285.

No. ce. |
n | ; No. ce.
i on -— Ba (OH), \ cidity
eit Total | ovo» | Albumi- 7 Ask | Iodine 10 as CIC | NEE: OH
Date. solids. | SHEA. noids. | Fat. (milk).) number. req. for vol. | bee: 10 :
atile fat acl. | required for
acids in one | 1 ee. milk.
gram fat. 1
June 11. 16:24} 3.12 4.15 | 8.71 . 403 36. 07 3. 40 062 07
12.) 14. 47 3.12 4.16 6.14 Sto Ve Rae cree 3.74 | 070 .07
13.) 14.25} 3.12 | 3. 94 6:65 |~. 74784 34,43 | 4. 86 068 | . 08
14.| 14.53 Soke 4.13 7. 67 .638 30. 68 | 4,34 | 065 | .07
15. 14. 34 3.12 3.99 6. 65 . 662 33.74 4.65 062 | 07
NO. 217
ah Eo OAS 2 Pe ahseke aes ace :
June 11. Toi) A 16 4.17 2. 03 . 590 28. 97 12. 52 . 149 | Eh I
12. 10. 82 4,16 3. 83 152 . 692 21.17 15. 09 - 158 | 18
1s.| 11. 30 4.16 3.97 2. 02 | - 751 29.10 14, 55 - 160 | .18
i Ls 11. 62 4.16 4,25 2.03 . 767 27.76 18, 07 - 160 | 18
NO. 290.
a — —- ss ee — ——_ +--+
|
June 11- 16. 35 3.12 4. 26 8.19 . 596 30. 51 Sea - 094 , . 106
12. 15. 133)" 3, 84 3.95 6. 64 . 620 28.79 5.51 - 118 | . 114
13. 15.71 | 3.33 4.03 TAS) — 259241 28. 85 7.94 | -119 | . 184
14. i Na Ve DY Sos 5 401°}, 7.14 OAS ER ee oes 6. 80 .114 130
15. 16, 22 | 3.84 4,25 7. 66 . 641 | 27.14 6. 64 115 - 130

171

98g a tt we eee |
£86 ih He ay Us Es
OTS my iii eerie YOON 5
SOG Mere | atonal Yoo
(UES Paria Gear ntirae Yoox
OSDir ia a TOoy
09% 'T 7 (ooo
CG LE le esa Ke Ate ce ace YOO,
086 TOS
LTE A I'v a
086 I ‘Vd
BL6 ‘a
L101 “a
696 mie
066 ‘a
BLL ‘ad
TL8 ‘a
OLL “a
“SpUNod
yeulue —_*UTTNOLEq1y

JOTTION = FO Pury

Yooyr |

-- op:
urd $"¢T Tae
[perigee seen ae ops

- opts
- op
op:

6 VOW
oe mek

---- op:

rT Jo oynq

Bee: ci: |

OF “TOL
80 ‘C01
[6 “LOL
8¢ “TOL
GC “TOL
88 “00T

80 COL
€L 001
CG “LOT
08°
16
06

10T
“TOT.
“TOT
‘TOT
“TOT
‘TOL
‘OOL
‘TOL

‘O1ng

-e1edu19} |

BULLOUW

OsVIONV

0 GOT
T GOL
6 TOT
9 “LOT
8° LOT
| 9 TOT
| 0°GOT
'L°TO1 |
0.001
| 9 LOL
0 °c0l
0°LOL
“TOL
“TOL
GOT
| ¥ LOT
| § TOT

9 TOT

“ud g |

"wd +

0 TOT
0301
9 “TOL
9 001
F001
9 66
8 TOL

‘F001

t 66

8 00L
0 COL
FOOL
0 TOT
PTO
F TOL
¢ T0l
6 001
8 TOL

“UW ZL

8

GOT
T Z01s
0 201
L ‘Tot
0 G0T
G TOL:
o C01
“9001
| FTL

UL uF

[pessnyy ‘aq Aq ‘paoy uoTTAYg yrouttod xp ULstOosL AK |

Qsll[eyuOM Ed xi

peas aie 7 BsOY BGFWEIOD
Asuvd

Pe Bees OLRM pee aes eI ee ¥. IAULLC

Aqneog

see TON
FRGORAR SE OIG FOSHN Ny 99 N

ony
(YaXts) CIPsSMoO ss
“BUTATOTL

atedete tarot vesees2 222-2 BUaTeD

GRE OSS OAG Ag o1osRW
(hgyqno,
m1lOss0q
Asreq

ddopes sod sectoueRsesedn ex)
Ponce pet pra eceer ATTOa

*OULB NT

“UYNdMIgN) YWM WOYNNd0U 78.Uuf 07 Snotdald NayD) play woNns Jo sp.Lovat atnyoiaduay — TTA ATA,

| ed

SH eta

Vt= Hu

i

ats

od

ot Do
4+aneos

of

-

*[BULIOU |
ysor ST
VAOQB
WOTZOVIY | WOT}IVOY

BSBASCeSCHAErANSDDOOnOeCoee

saaanadte

tat deena

*(BuLiou
@DBIVAR
oA0qe

*sanoq
LOF

“sanoy, | “sino

86

6 SOL
€ “COL
8 Z0L
6 GOL
ara
6 LOL
LGOr
¥ COL
0C0L

*sanoy
1B | (08
“UNaagny

akc) Se
| 9°ZOL | €°S0T
| #°SOL_ | F200

*samoy

81 91

ie oor

*SAMOl |

AAHQSRAMOSH
a

S 0 GOL

F 90T

F COL

0 FOL

ee the | $ “TOT

3G Sees ais L ‘cor
9 rte tps 0 Ro eat ole
F L°cOL Fag
G MAUS ee etepe
‘SAMO “SAO “Sunol “SALLOtL

FI at tL Ol

“uOTPOVIUL 19gjJB SIMO}

OF TOT
98 “LOT
G6 “LOT
86 ‘T0T
cero
88001
80 “GOL
6L00T
C3 TOL
0€ “TOT
L6 ‘TOT
06 “LOT
86 “LOT
GF LOL
OL TOT
G8 “O0T
SO*TOL
GF LOL

“oy
-viad ue}
[eua10U

‘SAnoy 6 ‘SINOY gi saNLoT g

| | vaRIIAY

[ro rtctterss* qerpequeuttaod xq
-* BsoY BYJUL[OD
“ss AsTeg
-- wi dupe g
~-* (puoodes) OIssogT
Peis iriosisniniels eprint i moe
“>> tung
* gossny
ee SOUR
Pape Sea anas -- dijsmop ssi
eho hens to eeee eet BUTATORL
pageHa SS -Bueley

“oleae y
“"pHgzqnod

*OULE NT

Ypm nNoynnooUr 78.uf 07 JUaNnhasgns pay. Uuoynjis fo sp.lodadt atnpnsadula |

‘ponurgaoj—]JA Wray

173

19% ‘1 08 “TOL
¢c6 09 ‘LOT
¥69 0& “O0T
C6L 0¢ ‘LOL
128 8F LOL
686 | 09 “LOT
[cl 1 0€ ‘TOL
866 89 TOL
088 it 66 O0T

9&6 1 GL COT
OFS 1 GL LOT
116 8€ “TOT
916 cP LOL
£98 SOD ¢9 “10T
F18 | WOON We possess wi" a F's Sey | CF ‘LOL
ODS stot (foe sae pages OOM eran sigs seis Ope Gz “TOT
9c8 Isat Pale ony Olen {oy See 0) Dasa eae | 00 00T
6LL Leen ores sess Woop jroo ed % 0G Gorey | OL TOT

-peutae | | ‘arnye19d u19} |
jo qysia My | “UI[MoIeqny Jo pury | “UOIQB[NDOUL JO 9}R(T | [eu10u
ont | | 9svieay

or ele oer eee

0 OL 0 GOL G TOT 0 COL Rey ee 8 : -qstqeyrommprod xq
G TOL 6 TOT F10L 6 AMES gs oes wrerossssses---BSO BYJUBLOD
0 ‘001 € “001 9 66 | $101 (et ogee ie a (puodes) ofssog
6001 0°01 F101 | L101 ces Gopees eo tems wate eS aac cae Asuvg
¢ TOL L101 L101 | 9 TOT | vr kuaye q
G ‘TOL 8 TOT ¢ ‘TOL | 9 LOT Facies Spe ramen tn ay ~--- Kqnvog:
€ I0L € 101 € TOL | § 10
8 TOL 8 TOT 8 101 € 101
€ ‘001 F10T ¢ “TOT | $001
FOL & S01 6 TOT 0 GOL
6 TOL 1 101 T TOT T 10 77 BUTATOT
1°66 8 L0T 8 TOT COL HAo SSG acne (een Reman Gata “-- BUaTey
| L001 L GOL 9 TOT PEL Olsson eg Sree ie assUy
¢ ‘101 0 G01 F101 TAA) ies Seal Sees ere a eerie mame Sates myaqnod
| T°LOT 8 101 8 TOL Ga Eas | neat Song Sg AO Sa ees “> uresseg
| L°T01 6 66 & G0 | L101 oS ete Aste |
F101 1°66 9 TOL GialOl ae eam et aa Ro eas ies Kex)
| 8101 9 001 € 01 € °d0L Ipesretmetmhonnsttstr a aia verses ATO
| | |
| | a3
| “ur dl ¢ “UL GI “UL "B® 9 “urd + “OULB NT

Tessuy “iq Aq ‘paoy woNRIG quowWtiodxy WISMOOSTA\

“UOuNNIOUL puodzas 07 h.ipUunuyald puay fo sp.Loddd aingv.ladUMay—*JITA ATAV,,

174

Hl | | a: cae a See le bs

Leeks we: 6°6 6 "FOL 9 “601 L°SOL F COI | OR OL” Mee pee ery ees “ystTequomsedxgy | 6T
“od ae har L ‘GOL 9 °ZOT 8 “101 8 “TOL 09 “LOT Tutto" BRON BYZWRTOD | ST
“0d 8% 8°& 8 TOL 9 "201 0 “801 TOL 08 00T "7s s===""==(puoaes) orssog | ZT
0d 0"% $s 9 "FOL 0°SOr 6"e0L O'2OE | OSSTOT j227°727 Ho ip et Perce mee a a
“od "8 0 "GOL. 9 F0T 6 ‘TOL | €°10L ) | SPLOT voooertesess*wrkored | eT
‘od LT "1 1201 9°z0t 8 "IOI 9101 = 09TOL VE eiae ~- ANYOg | IT
“od 1% jac 9201 °e0r "101 G'00TS Fl OBMDOES « eye ss seen sesame snares “-----uung | OT
‘od P's Ge 6 “FOL £801 rar) | S"Tor | g9 TOT ““goS33nN WON | 8
‘snopnosequy, 0"E o'e © POL US0L Proust 0 "TOL 86 “00T SRE eos BART ALR
“POET ION | 20 1 ¥ COL farcile FOr ¢ ‘Zl zl'sor “ooos= drpsaog | 9T
‘od 6 0% "201 F°ZOT 6°T0T SOT BE ON ge ets rane eo peo cn nae ales 7" "BUTATARL | CT
‘od 00 8°0 8 °10T 1101 9 "TOT L°LOE =| 88 °T0T “77777 wuaTeEDy | g
‘snoqnoreqny, | % "0 "lr F2OT | 0°Z0T S10r || |3°3OL =| SF “TOT "TTT OIasEW | G
od o') g"0 a ¢ ‘201 STOv | + TOT =| S9°T0T “--"= THyWQnog | ¢
“POET ION | TT rl | 6°Z0R | F101 3101 ‘10 | SFTOL 77" upessog | Z
‘od im ir O'zOL | L TOT LE | 6 “TOT 2 “TOT “riers Kereq | 6
‘od 10 L°0 error. | ‘Tol [ “101 erOT = || OO“TOT | CRS Pongo ker ae hep
“snOTMIIOGILT, | g°Z re Dara Tol 6 “FOL LAGOE 90k TOE eats ase seers re Pegs oe seers ATOR | T
‘[BULLOW [Budo Tt
. : JRO OLY | OOBIOAV | “S.unOY *SInlOy ‘sanoy | *sanoty *SITLO1 *SINOL Me Be ¥ vullou ; zs
Asdoquy | “eaoqe | eaoqe rz 02 SI | ot el { Or I san0yg “sanoy ¢ | astaoay UIE NT
Moyovey Tory vvay_ | | |

“MOTPR[MIOUL Jo}yB Sanopy

: “wOYDnI0UL Japfp ainzowadwa

*pouumgyuoj—]ITA ATA

a

175

TABLE [X.—/teaction in temperature with tuberculin in tuberculous guinea pigs at differ-

ent dates after infection.

i

Before injection. July 20 | 10 a.m.

No. 426 IT.

|
1
|

No. 426.

Tem. | "Tem: | | | Tem-
‘pera-| Date. Time. pera-| Date. | Time. | pera-
| ture. | | ture. | | ture.
SS IRE se Sr Ce a aa ena Sen
“102, 6 | | Suly 21) 10am. 103.4 | July 22) 9a.m...| 102.4

Injected e ee. fabereulin:

injected 3 ec. tuberculin. |

ERE a ce. Sein.

i Suly 20 | (12m.... 102.8 | July 21 aw 104.4 July 22; am..| 103.2
After injection) July 20 | 2p.m-..; 103.6 | July 21 | 2p.m- | 104.4 July 52 | lp.m...| 104.0
July 20 | 4p.m...' 103. 7 | July 21] 4p.m. | 103.4 | July 22} 3p.m...| 103.2
No. 424. ! No. 424 11. No. 429 II.
' Tem. | | Tem- | Tem.
Date Time. pera- Date. Time. | pera Date. Time. | pera-
| ture. | ture | ture.
a (ees es ! osm en le ie 2 2 EL BEE
Ds i | || | j |
Before injection.| July 24 | 10a.m-. 103.2, July 25 | 10a.m-.. 103.4 July 26 10a.m-.. 102.8
|

Injected ee. ogirereian. i

Injected 3 ce. “mneveainin.|

_ Injected gece tuberculin.

104.2

|

103. 2

July 24 12m... | July 25 | 12m... July 26} 12m....' 104.6
After injection | July 24 2 p.m...| 104.4 | July 25 | 2 ee 103.8 | July 26 | 2p.m..-| 103.8
| July 24 | 4p. m..- 103. 6 Py 25 | 4p.m...| 103.2 || July 26 | 4p.m | 103. 4
| |
| No. 429 TIT. No. 42 IIT. No. 426 1V
Tem- | Tem- Tem
Date. Time. | pera-| Date Time. | pera- Date. Time. | pera
ture. | ture. ture
are a on es [aes | iar eal oF | ce el BT Pe esa
Betore injection. July 27 | 1a.m-.. 102.4 July 28 | 10 a.m... 102. 6

i

103.2 July 29 | 10a.m..

Injected 3 cc. orineserEn. i Injected ace tuberculin.

“Tefen? ee ‘alcean sh.

i !
July 27 | 12 ae fa 103.8 | July 28 | 12m....| 104.0 | July 29} 12m-.-../ 103.8
After injection) July 27 | 2p 103.0 || July 28 | 2p.m..-| 103.8 ), duly 29 | 2p.m...| 104.0
| July 27/| 4p 103.4 | July 28 | 4p.m...| 103.6
| ! eal ! |
| No. 430. fH No. 430 II. No. 425
Tem- || Tem E | Tem.
Date. Time. | pera-|) Date. Time. | pera Date Time pera-
' ture. | ture ture.
pc Et a ee ee it Ue Le | a CALS, EB) |S cet eee |
Refore injection -! | July 20 o| 1 10 a.m - 103: 0'| ! July | | 10 a.m .-| 102.6 i July 22 | 9a.m..-| 103.6

Injected } ce. tabereulin. | | Injected 4 ce. tuberculin. |

Injected 3} cc. tuberculin.

ii

} 11a.m..)

|
| Suly 20 | 12 ™m.- 102. 8 | July 21) 12m....) | 103.6 July 22 | ' 103.8
After injection July 20 | 2p.m...| 103.6 | July 21 | 2p.m.-...} 103.6 | July 22} 1p.m.../ 104.2
| July 20 | 4p.m...| 103.6 ! July 21) 4 p.m. -| (Ube 4 | July 22 | 3p.m...) 104.0
| j |
| No. 425 Il. No. 421 No. 421 IL.
| Tem- | |e | Tem-
| Date. Time. | pera Date Time. | p | Date. Time. | pera-
al ture Dis 2 | | ture.
ee eee = See : WeICSL Hoe, II sa esl eases
H | li H
Before injection.| | July 24 | | 10 a.m. 102.0 | July 25 | 10a.m..| 102.6 | July 26 | 10 a.m .. 102.8

| iN. i
4 (ee

| Injected } ce. aes

“Tnjected 3 ce. tuberculin. | Tajected $ ee, tuberculin. |

J ais 4 |

: ame
After injection) | ie cn | 2 p.m.
| July 24 4p.m.

=<] | 103. e | i} | Suly 2 12m. | 104.6
--| 103. ! | July 26 | 2p. m...| 103.6
--| 103. A | July 36 ae 103. 6

TABLE

176

:

No. 430 TV.

IX.—Reaction in temperature with tuberculin in tuberculous guinea-pigs at differ-
ent dates after infection—Continued.

No. 425 ITT.

| No. 430 III.
| Tem- Ten- Tem-
Date. | ‘Time. | pera- Date. Time. pera-| Date. Time. — pera-
| ture. | ture. ture
) | '
13 pone ee aS | = aoa aoe = wees ate
We | i = |
Before injection. July 27, 10a.m-.. 102.6 July 28 | 10a.m-.. 103.0) July 29° 10a.m-.. 103.6
z Injected § cc. tuberculin. | Injected } cc. tuberculin. | Injected }ce. tubereulin. —
July 27 | 12m..../ 104.2 || July 28 | 12 ae 104.2 | July 29 | 12m 104.0
After injection July 27 | 2p.m..-) 102.4 || July £8 | 2p.n -.| 104.3 aly 29 | 2p. m. 104. 6
j July 27! 4p.m-...| 103.6 | July 28 | 4p. rae -| 104.0 | |
No. 428. No. 435. No. 433.
| Tem Tem- | Tem-
Date. Time. | pera Date. Time. pera- || Date. Time. | pera-
) ture ture. ae _ ture.
a ae Ss rs = mis —
‘Before injec- | | | i
HOM 222 = nio July 20 | 10a.m-.) 104.0 | July 21 | 10a.m-.) 102.4 | July 22 be 9 a.m. 102. 2
3 ! : =i ws
Fe | Injected $cc. tuberculin, || Injected } ce. tuberculin. | Injected 4 ce. tuberculin.
pe
oO at —— — ee —
After injec-§| July 20 | 12m-.... 103.4 || July 21 | 12m. 102.6 || July 22 | lla.m-.| 101.2
x nine He July 20) 2p.in... 103.4 || July 21 | 2p. m... 102.6 || July 22 | 1p.m 101.8
NN ae re July 20) 4p.m:.. 102. 6 | July 21 ‘4 p. m... 102.6 July 22.) 3p.m 102. 4
i
No. 432 No. 431. | No. 435 11.
= = = — | ina = et
| Tem Tem- | Tem-
Date. Time. pera Date. Time. pera- Date. Time. | pera-
ture ture. | | ture.
— = a: =< ees ss |
(Before injec- |
TO Mtetes coe July 24 | 10a.m--.| 101.2 |) July 25 , 10a.m-..) 101.6 || July 26 | 10a.m-.| 102)6
3 > peer Grae? iors © ene ees Pat
3 ( Injected 4 cc. tubereulin. | Injected 4 cc. tuberculin. | Injected 4 ce. tubereulin.
ms ‘Th 2 T ee ee Sista |
Alar Side | July 24 | 12m....| 100.6 || July 25 | 12m 102.0 | Shale 26 | 2ameseeat 103.6
see Jec-2| July 24 | 2p.m.--| 101.6 || July 25 | 2p.m...| 102.8 || July 26 | 2p.m_.-} 103.0
ae te July 24 | 4p.m..-) 102.4 || July 25 | 4p.m --| 108.0 || July 26! 4 p.m_-:) 10238
: No. 436. | No. 427 | No. 428
| Tem. Tem- | Tem
Date. Time. | pera Date. Time pera Date Time pera
ture ture ture
Before injec {
tion 232-52 July 27) 10a.m--.| 102.6 July 28 10a.m-.. 101.8) July 291} 10a,.m.. 102.8
“ Ee | = ee ee
= {
oO Injected $cc. tuberculin. | Injected 3 cc. tuberenlin. | Injected 3 cc. tuberculin.
tise ay a Gt July 27] 12m....) 102.4 ||) Juiy 28 | 12m. ee: 6 | July = | 12m....| 103.2
atin u July 27 | 2p.m..- 103.0 || July 28 |-2p. m...) 102.2 |) July 29 | 2p.m...| 104.0
FE a | July 27 103.0, July 28! 4p. m... 102.0 |

4 p.m...

Checks.

177

TABLE X.—Reaction in temperature with tuberculin in tuberculous guinea pigs at different
dates after infection.

No. 482. No. 482. No. 486.
Tem- Tem. Tem-
Date. Time. | pera-|| Date. Time. | pera- Date. Time. | pera-
i ture. | ture. ture.
Before injection.| Oct. 12 | 10 am. 101.8 || Oct. 16 | 9:30a.m. 102.6 || Oct. 18 |9:30a.m.! 102.2

Injected $cc. tuberculin.

Injected 3 cc. tuberculin.

Injected $ cc. tuberculin.

Oct. 16 | 11:30a.m.| 102. 4

Oct. 12 | 1:15p.m.| 102.8 Oct. 18 |11:30a.m.| 102.4
After injection.{| Oct. 12 | 3:45p.m.| 103.0 || Oct. 16 |3p.m---| 102.2 || Oct. 18 |3:30p.m-| 101.6
| Eeanaeoces lscogsedebalasecooal|lessdadasecloe scassceg|aasacs+ || Oct. 18 |6p.m...| 102.4
{

No. 482 No. 486 Cage ated July. 10, 1893.)

Tem- Tem- Tem-

Date. Time. | pera-|} Date. Time. | pera-|| Date. Time. | pera-

ture. ture. ture.
Before injection.| Oct. 25 | 9:30a.m-/ 102.0 || Nov. 1 | 9:30 a. m 102.2 || Nov. 8|10a. m-.-} 103.0

Injected 3 ce. tuberculin.

Injected 4 ce. tuberculin.

Injected 4 ce. tuberculin.

Oct. 25 |12m-....| 102.8 || Nov. 1]12m..... 102.2 || Nov. 8 | Zane 105.0
Beeerice Oct. 25 |2p.m-.-| 102.6 || Nov. 1|)2p.m-.-..} 102.6 || Nov. 8|2p.m-..| 106.2
After injection-)| O¢¢, 95 |4p.m- .| 102.4 || Nov. 1/4 p.m -..| 103.2 |) Nov. 8|/4p.m...| 105.0
; Oct. 25 | 6:15 p.m.| 102.2 || Nov. 1]|6p.m ---} 102.4
No. 487 (a). No. 487 (a). No. 484 (d).

| Tem- Tem- Tem-

Date. Time. | pera- Date. Time. | pera-|| Date. Time. pera-

ture. ture. ture.

Before injec-

tion ......-- Oct. 12 |10a.m-.--| 103.0 || Oct. 16 |9:30a.m.| 103.4 || Oct. 18 | 9:30 a.m.) 102.4

Injected 4 cc. tuberculin. || Injected 4 ce. tuberculin. || Injected } cc. tuberculin.

i
(After injec- (| Oct. 12 |1:15 p.m.| 104.0 || Oct. 16 | 11:30a.m| 103.4 || Oct. 18] 11:30a.m.| 104.0
tion --2--- - Oct. 12 | 3:45p.m.| 103.8 || Oct. 16 | 3p.m --..} 103.0 || Oct. 18] 3:30 p.m.| 103.0
Ree (| Pte aece Saline n cis ese slurs Oct. 16 | 6 p.m...} 102.4 || Oct. 18 |6p.m....|/ 102.8
(Inoculated July 10, 1893.)
No. 487 (a). No. 484 (d). No. 425.

Tem- Tem- Tem-

Date. Time. | pera-|| Date. Time. | pera- || Date. Time. | pera-

ture. 3 ture. ture.

Before injec-
UND seScaa6e Oct. 25 | 9:30 a.m.) 103.2 || Nov. 1 | 9:30a.m.| 101.8 || Nov. 8]10a.m-.-.} 103.4
g
2 Injected 4 ce. tuberculin. || Injected 4 cc. tuberculin. || Injected 4 ce. tuberculin.
5
ene Oct. 25 |12m ....| 103.2 || Nov. 1 | 9:30 a.m-] 102.2 || Nov. 8|/12m-....] 104.2
Aver injec: |! Oct, 25 |2p.m.-.| 103.0 || Nov. 1|2p.m-..| 102.6] Nov. 8|2p.m...| 106.4
Saree Oct. 25 |4p.m...] 103.0 || Nov. 1|4p.m-.-.} 102.6 | Nov. 8|4p.m...| 105.8
(| Oct. 25 | 6:15p.m.} 102.8 | Nov. 1)6p.m-..-} 102.4 |;
12

2891—No. 7

178

TABLE X.—Reaction in temperature with tuberculin in tuberculous guinea pigs at different

Before injection.

‘ dates after infection—Continued.
No. 483. No. 485. No. 483.
Tem- Tem | Tem-
Date. Time. | pera- Date. Time pera Date. Time. | pera-
ture. ture ure

Oct. 14 9:30 a.m.| 102.8

Injected § cc. tuberculin.

Oct: 16

Injected 3 cc. tuberculin.

Injected 4 cc. tuberculin.

| Oct. 18 | 11:30 a.m

Oct. 14 | 11:30a.m) 103.8 || Oct. 16 | 11:30 a.m) 102.0 104. 0
After injection.<} Oct. 14 | 2:30p.m.| 103.8 || Oct. 16|3 p.m-..| 102.8 | Oct. 18|3:30p.m.) 103.4
Sch eobscdlbeeseiem ed lFneaboe Oct. 16 |6p.m 102.6 / Oct. 18|}6p.m-...} 103.4

(Inoculated Oct. 7, 1893.)

No. 485 No. 483 No. 485.

Tem- | Tem- Tem-

Date. Time. | pera- |; Date. Time. | pera-|| Date. Time. | pera-

ture. ture. ture.
Before injection.| Oct. 25 | 9:30a.m.| 102.6 || Nov. 1 | 9:30a.m-.) 102.4 | Nov. 8 | 10a.m..-| 102.0

Injected 4 ce. tuberculin.

Injected 3 cc. tuberculin.

Injected 4 ce. tuberculin.

Oct. 25 | 12m .--..| 103. F aay, 1 ema aOe 6 ox 3 1203. 103. 6
PEARS Oct. 25 |2p.m-..-} 103. Nov. 1)|2p.m..-} 102.6 ov. 2p.m-...| 104.0
After injection -4) Oct. 95 | 4 p.m...| 103.0 || Nov. 1|4p.m-..| 103.4 || Nov. 8|4pm...| 103.0
Oct. 25 | 6:15 p.m-.} 103.0 || Nov. 1|6p.m-..-| 103.0
No. 486 (0). No. 481 (ce). No. 488 (b).

Tem- Tem- Tem-

Date. Time. | pera- || Date. Time. | pera-|| Date. Time. | pera-

ture. ture. tire.

Before injec-

COM sees eee
n
ae}
Cc
eo
oO

After
MOR. osc.

injec- :

Oct. 14 | 9:30 a.m.| 102.2

Injected 4 cc. tuberculin.

Oct. 14 | 11:30a.m| 101.8
Oct. 14 | 2:30 p.m.| 102.8

Oct. 16 | 9:30 a.m-.| 103.0

ea

Oct. 18 | 9:30a.m.| 102.0

Injected 4 og. tuberculin.

Oct. 16 | 11:30a.m| 102.6
Oct. 16 |3p.m..-} 102.8
Oct. 16|6p.m...| 102.8

Injected } cc. tabereulin.

Oct. 18] 11:30a.m) 102.6
Oct. 18|3:30p.m.| 101.6
Oct. 18|}6p.m-. -| 102.8

Before injec-
TION aisles 1='el0

Checks.

After injec-
TOW sees

—_—_——— —_—-——

LEFe ’07

(Inoculated Oct. 7, 1893.)

No. 481 (c). No. 488 (6). No. 481 (c)
Tem- Tem- Tem-
Date. Time. | pera- Date. Time. | pera- || Date. Time. | pera-
ture. ture. ture.
|
Oct. 25 [esses 103.0 | Nov. i

Injected 4 cc. tuberculin.

Oct... 25. |12m-.222 | 108.
Oct. 25|/2p.m...!

Oct. 25|4p.m-.-i 102.
Oct. 25 | 6:15 nm 102.

aoncaom

9:30a.m. | 102.0

Injected 4 cc. tuberculin.

Noy.. | iin eee 101.6

Nov. 25) 2-p.m- 22) 1022044

Nov. 1/4p.m 102. 2 |

Nov. 1/6 p.m...) 102.2 |
o

Nov. 8 ah = fl 103.6

Injected 4 cc. tuberculin.

Nov. 8}12m....) 103.6
Nov. 8|2p.m...} 103.8
Nov. 8|4p.m...| 103.6

y

f
ie ln,

—— ea

|

0 002 850 31

1%)
”
Lu
oa
Oo
ae
O
Oo
LL
Oo
>
ao
<
a
oe
=I

Wu