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HUMAN AND BOVINE INFECTION IN TUBERCULOSIS.
1058 his course and to qualify as early as possible. It must be remembered that time is of the essence of the matter in the preparation of the doctor. It is not merely one of several desirable requirements, which may, however, on adequate emergency be dispensed with without affecting the result. It is, therefore, in the highest degree desirable that the ranks of the future medical profession shall not be exhaustively drained through the abandonment, even though temporary, of their curriculum by too large a proportion of those in training for medicine. HUMAN AND BOVINE INFECTION IN TUBERCULOSIS.
that infection from a bovine source is a comparatively rare but by no means negligible danger, is on the whole substantiated, as against the position originally adopted by Koch that the disease in cattle is of little or no importance as a source of human tuberculosis. ____
AN
UNCANNY EFFECT OF SHELL ARTILLERY.
MORE than once in the accounts of the present reference has been made to ,the use of shells which on exploding deal out death on all sides, leaving the victims fixed in their last attitude of life. They are said to have been left in life-like groups, remaining in exactly the position in which they died, some in the act of shooting still levelling the rifle, others dictating despatches, others lighting a cigarette, and so forth, the whole suggesting a group of waxwork bodies at Madame Tussaud’s. That dead bodies can remain in the upright position without support from without is, of course, absurd, but it is interesting to point out that the favourite modern explosive is tri-nitro-toluol, and this gives off incidentally a large volume of carbon monoxide gas, which when inspired produces a healthy pink and life-like appearance in the corpse. Imagination has probably filled in the picture as to these victims appearing to retain a living posture. It will be remembered that carbon monoxide rapidly forms a characteristic compound with the haemoglobin of the blood, which then assumes a pink, rosy colour, owing to the formation of carboxyhasmoglobin. If a puff of tobacco smoke be directed upon a film of blood the change from red to pink is easily observed. Tri-nitro-toluol is obtained in crystalline form by the action of nitric acid on toluol, an analogue of benzene, and obtained by rectification of coal tar. The shell is filled by simply pouring the melted crystals into it, the mass then being allowed to solidify. It burns quite harmlessly and with the production of dense volumes of smoke when a light is applied to it. To get its explosive effect a detonator is employed, which is generally fulminate of mercury. ’Owing to the fact that it does not contain sufficient oxygen in its own molecule to burn the carbon and hydrogen completely into carbonic acid gas and water respectively, a considerable volume of carbon monoxide is produced, which may be accountable for the stories about its victims having the appearance of being alive. war
IN view of the doubt that still exists as to the of infection derived from cattle in the production of tuberculosis in man attention may be directed to a useful summary of the cases hitherto published which bear on this problem, compiled by Park and Krumwiede’and published in the Reports of the New York Health Department. The total number of cases reviewed is 1511, of which over half (831) were cases of pulmonary disease. In this group bovine infection appears to be almost negligible, only four among this large number of cases showing infection from this source. Again, no instance of bovine infection was discovered among nine patients who suffered from tuberculosis of the axillary or inguinal glands, a remarkable contrast to the group of cases exhibiting cervical adenitis in which so far as subjects under 16 years of age are concerned the figures for the two sources are not far from equalviz., 51 human and 44 bovine. If we take together all cases in which the infection appears to be abdominal in origin a still more noteworthy proportion is due to bacilli derived from cattle and presumably taken into the system with infected milk. Thus, taking all ages together there are recorded 66 of human infection against 59 of bovine, while in children under 16 there are 34 of the former to 52 of the latter-a striking preponderance. On the other hand, in opposition to the view which has been advanced that tuberculosis of bones and joints, a common affection of children, is of bovine origin, it appears that only 4 cases out of 104 of such disease at all ages were of this nature. Taking the whole number of the cases together, there were 1363 of human origin, 137 of bovine, and 11 instances of mixed infection. The importance of tuberculous milk CHOLERA IN AUSTRIA. in the causation of infection of the cervical glands is borne out by the researches of Mitchell2 at the IN of official attempts to reassure the public, laboratory of the Royal College of Physicians, Edin- says spite a well-informed correspondent, it seems that burgh, who found that of 80 cases of cervical adenitis the cholera epidemic in Austria-Hungary has in children 71, or 88 per cent., were due to bovine assumed serious proportions. An official com-_ infection. Of 12 fatal’cases of tuberculosis in munication from the Medical Department of the children, 4 in which the disease appeared to originate of War, dated Oct. 12th, refers to cases in the mesenteric glands were due to the same Ministry which have occurred at Vienna and Budapest, and source, while 7 in which the bronchial glands were at eight or nine provincial towns. Die Zeit, of the seat of origin, and 1 case of genito-urinary Vienna, published on the following day a statement disease in which the seat of original infection was from a Budapest doctor who, while dismissing any not ascertainable, were caused by the human type for panic, admits that the epidemic has of bacillus. Examination of the milk-supply of grounds been on a considerable scale. He ascribes the outEdinburgh showed the presence of tubercle bacilli break entirely to the presence in Hungary of in 20 per cent. of the samples taken. The Russian and Serbian prisoners and fugitives from view generally prevailing in this country, therefore, the eastern provinces of the Dual Monarchy. " The area in which the epidemic has raged is a large 1 The Relative Importance of the Bovine and Human Types of " Tubercle Bacilli in the Different Forms of Tuberculosis. Collected one," our correspondent continues, because insuffiStudies from the Bureau of Laboratories, Department of Health, City cient precautions were in the first instance taken of New York. Vol. III. 1912-13. at the various concentration camps. But good 2 A of of Tuberculosis the in Bacteriological Study Lymph Glands Children, Edinburgh Medical Journal, September, 1914. results have now followed the strenuous efforts
importance
____
that infection from a bovine source is a comparatively rare but by no means negligible danger, is on the whole substantiated, as against the position originally adopted by Koch that the disease in cattle is of little or no importance as a source of human tuberculosis. ____
AN
UNCANNY EFFECT OF SHELL ARTILLERY.
MORE than once in the accounts of the present reference has been made to ,the use of shells which on exploding deal out death on all sides, leaving the victims fixed in their last attitude of life. They are said to have been left in life-like groups, remaining in exactly the position in which they died, some in the act of shooting still levelling the rifle, others dictating despatches, others lighting a cigarette, and so forth, the whole suggesting a group of waxwork bodies at Madame Tussaud’s. That dead bodies can remain in the upright position without support from without is, of course, absurd, but it is interesting to point out that the favourite modern explosive is tri-nitro-toluol, and this gives off incidentally a large volume of carbon monoxide gas, which when inspired produces a healthy pink and life-like appearance in the corpse. Imagination has probably filled in the picture as to these victims appearing to retain a living posture. It will be remembered that carbon monoxide rapidly forms a characteristic compound with the haemoglobin of the blood, which then assumes a pink, rosy colour, owing to the formation of carboxyhasmoglobin. If a puff of tobacco smoke be directed upon a film of blood the change from red to pink is easily observed. Tri-nitro-toluol is obtained in crystalline form by the action of nitric acid on toluol, an analogue of benzene, and obtained by rectification of coal tar. The shell is filled by simply pouring the melted crystals into it, the mass then being allowed to solidify. It burns quite harmlessly and with the production of dense volumes of smoke when a light is applied to it. To get its explosive effect a detonator is employed, which is generally fulminate of mercury. ’Owing to the fact that it does not contain sufficient oxygen in its own molecule to burn the carbon and hydrogen completely into carbonic acid gas and water respectively, a considerable volume of carbon monoxide is produced, which may be accountable for the stories about its victims having the appearance of being alive. war
IN view of the doubt that still exists as to the of infection derived from cattle in the production of tuberculosis in man attention may be directed to a useful summary of the cases hitherto published which bear on this problem, compiled by Park and Krumwiede’and published in the Reports of the New York Health Department. The total number of cases reviewed is 1511, of which over half (831) were cases of pulmonary disease. In this group bovine infection appears to be almost negligible, only four among this large number of cases showing infection from this source. Again, no instance of bovine infection was discovered among nine patients who suffered from tuberculosis of the axillary or inguinal glands, a remarkable contrast to the group of cases exhibiting cervical adenitis in which so far as subjects under 16 years of age are concerned the figures for the two sources are not far from equalviz., 51 human and 44 bovine. If we take together all cases in which the infection appears to be abdominal in origin a still more noteworthy proportion is due to bacilli derived from cattle and presumably taken into the system with infected milk. Thus, taking all ages together there are recorded 66 of human infection against 59 of bovine, while in children under 16 there are 34 of the former to 52 of the latter-a striking preponderance. On the other hand, in opposition to the view which has been advanced that tuberculosis of bones and joints, a common affection of children, is of bovine origin, it appears that only 4 cases out of 104 of such disease at all ages were of this nature. Taking the whole number of the cases together, there were 1363 of human origin, 137 of bovine, and 11 instances of mixed infection. The importance of tuberculous milk CHOLERA IN AUSTRIA. in the causation of infection of the cervical glands is borne out by the researches of Mitchell2 at the IN of official attempts to reassure the public, laboratory of the Royal College of Physicians, Edin- says spite a well-informed correspondent, it seems that burgh, who found that of 80 cases of cervical adenitis the cholera epidemic in Austria-Hungary has in children 71, or 88 per cent., were due to bovine assumed serious proportions. An official com-_ infection. Of 12 fatal’cases of tuberculosis in munication from the Medical Department of the children, 4 in which the disease appeared to originate of War, dated Oct. 12th, refers to cases in the mesenteric glands were due to the same Ministry which have occurred at Vienna and Budapest, and source, while 7 in which the bronchial glands were at eight or nine provincial towns. Die Zeit, of the seat of origin, and 1 case of genito-urinary Vienna, published on the following day a statement disease in which the seat of original infection was from a Budapest doctor who, while dismissing any not ascertainable, were caused by the human type for panic, admits that the epidemic has of bacillus. Examination of the milk-supply of grounds been on a considerable scale. He ascribes the outEdinburgh showed the presence of tubercle bacilli break entirely to the presence in Hungary of in 20 per cent. of the samples taken. The Russian and Serbian prisoners and fugitives from view generally prevailing in this country, therefore, the eastern provinces of the Dual Monarchy. " The area in which the epidemic has raged is a large 1 The Relative Importance of the Bovine and Human Types of " Tubercle Bacilli in the Different Forms of Tuberculosis. Collected one," our correspondent continues, because insuffiStudies from the Bureau of Laboratories, Department of Health, City cient precautions were in the first instance taken of New York. Vol. III. 1912-13. at the various concentration camps. But good 2 A of of Tuberculosis the in Bacteriological Study Lymph Glands Children, Edinburgh Medical Journal, September, 1914. results have now followed the strenuous efforts
importance
____