Vol. 60, 1909 - University of North Carolina at Chapel Hill

ORIGINAL COMMUNICATIONS. 297
sand of ourown people in the United Stales, firming the theory of the specific infectious
twelve thousand in the City of New York nature of the 'Hsease.
alone, agrgregating an average of about It remained, however, for the distinguishthree
thousand persous each day in the year, ed Dr. Koch to demonstrate the absence of
with a possibility of indefinite continuance tubercle bacilli in other than tuberculous
of these conditions, is it not high time for ev- conditions. He even accomplished the
ery father, mother, and child to buckle on the successful inocculation of animals from
armor of warfare to save our nation from pure artificial cultures of tubercle bacilli,
parasitic decay and destruction? after the elimination of all extraneous ele-
I have endeavored to portray, in a con- ments, and the removal of all accessory
servative manner, the great havoc that sources of error. Dr. Koch thus estabthis
greatest of all scourges is playing with lished the real cause of tuberculosis
the human family, and will now jiroceed to among man and animals by the discovery
give yon a few additional ideas of the na of the bacillus and confirmed it by the results
ture and chief characteristics^f this malady of inocculation experiments,
before otTering some plain but scientific The apparent etiologic identity of all
facts for its prevention and extermination, forms of tuberculosis in different species
Before going to war with so formidable a was determined also upon the basis of the
foe it might be well to ascertain, if possi- characteristic histologic structure of the
ble, the strength and chief traits of our primary tubercle. Recently a mass of evieneuiy,
giving due consideration to the va- dence has been presented liy numerous obrious
lines of procedure, the modes of inva- servers.bothfor and againsttheacceptanceof
si^n, the habits ajid even the topography essential ditference of essential difference in
and climate of the country. I'ntil this is the cultural characteristics, virulence and
done we cannot expect as good results from powers of transmission. While we are of
our efforts toward the overthrow of this tlie opinion that human and bovine tuberking
of all diseases, culosis have the same origin and can be
We are all familiar wi'h Dr. Koch's dis- transmitted from one to the other, yet there
covery of the bacillus tuberculosis in the is great room for speculation: but snfiice it
year 1S,S2, which revealed to the world not to say we are more interested in eradicating
only the hiding places, bul the habits, act- it from our fellow creatures, whose lives are
ual work-shops and full paraphernalia of more precious than gold or silver, than we
this secret foe. Hy an original method of are in eradicating it from the lower anidifferential
staining. Dr. Koch succeeded in mals.
isolating the tubercle bacillus and demon- In this connection, if you will permit the
strated its presence in infected areas in all digression, I am of the opinion that every
parts of the body. Previous to this, char- up-to-date physician should be able to use
acteristic tubercle formation had been re- and own a first-class microscope with an
cognized in the scrofulous affection of oil-immersion lens that he may diagnose
glands, bones and joints, although the pre- his cases at his office instead of sending
cise infective agent had not been discover- specimens off to the specialist. There isno
ed. The recognition of nodules or tubercles good reason why every general practitioner
in the lungs was obtained about the middle who has any aspiration to keep abreast of
of the seventeenth century. Ai the begin- the times, should not do his own bacterioning
of anatomic investigation with the dis- logic work- The diversion from the routcovery
of ca'Mty formations and pus collect- ine part of his work and fascination of
ons, numerous conjectures were offered as spending at least one afternoon of each
to the pathogenesis of the disease. week in laboratory work, saying nothing
The first efforts towards the inoculation of the consolation of being able to diagexperiments
were made in tlie beginning nose his own cases without outside assistof
the nineteenth century, but were not at- ance, is sufficient to amply reward him for
tended with clearly definable results. Vir- the outlay in the purchase of a microscope
chow cleared the atnK)sphere to some extent with all the necessary equipment. Of course
by exi)oundingthe jjathologic andhistolog- if heexpects to do good and satisfactory work
jic structure of tubercle. Villemin, in l,S6.=i, he should take a special course in microonducted
a series of inoculation e.xperi- scopy and bacteriology provided he did not
aents of the greatest value. In addition get this knowledge in his regular college
;o introducing into animals an infective courge.
Material obtained from tuberculous tissues In the study of the tubercle bacillus in
md the sputum of consumptives, he inject- iis various aspects, we find some very iui-
;d into a second group some non-tubercu- portant features to consider, not only in
ous pus, and in a third, a caseous matter reaching a clear diagnosis, but also in ma-
'rom tuberculous cows. A tul)ercular de- king a prognosis. In studying the anatomy
Josit was found after these injections con- of the tubercle bacillus we find the length