BY E. H. BARTLEY, M. D.,

MILK FROM TUBERCULOUS COWS.

No subject in preventive medicine is receiving more attention at present than tuberculosis.

The following notes of experimental studies are worthy of careful

note.

Bollinger (Centralblatt f. allgm. Gesundh.) gives the results of his experiments with the milk of twenty tuberculous cows. He tested the virulence of the milk by intra peritoneal injections in guinea pigs. In five cases of advanced tuberculosis, the milk was infectious four times; in six cases in which the disease was of a medium grade, he got four positive and two negative results; in nine cases where the disease in the cows was in the earlier stages, the inoculations gave three positive and six negative results. Fifty per cent. of the experiments gave positive results. The danger of infection from the milk is greater therefore in the later stages of the disease, and is particularly great when the udder is the seat of tubercles. Bang tells us that he found in the dairy establishments of Copenhagen, within a few months, not less than twenty-seven cases of advanced tuberculosis of the udder. In one of these, in which the milk presented a normal appearance, the microscope revealed an abundance of bacilli. Some of the cover-glass preparations contained so many that two hundred could be counted in each field of view.

Another series of experiments upon the same subject has lately been conducted by Hirschberger, a German physician. He injected the milk from tuberculous cows into the peritoneal cavity and under the skin of guinea pigs.

None of the experimental animals died of septic peritonitis, or other disease than tuberculosis. Fifty-five per cent. of the animals used contracted tuberculosis, and the possibility of spontaneous tuberculosis was carefully excluded.

In cows which were greatly emaciated the milk was nearly always infectious, while in those in fairly good condition about thirty per cent. of the inoculations gave positive results. The milk was thus shown to be infectious even in the earlier stages of the disease or before the udder became diseased.

Dr. Ernst, of Boston, has lately published the results of his investigations upon this subject in the interest of the Massachusetts Society for the Promotion of Agriculture, Thirty-six cows suffering from tuberculoses other than of the udder were used in his investigations, and 117 samples of milk from them were examined; 17 samples from ten different cows were found to contain the bacilli of tuberculosis. Inoculation ex

E. H. BARTLEY, M. D.

periments upon well animals gave positive results in fifty per cent. of the cases treated. Feeding experiments were less successful, but he induced the disease in several calves and young pigs. He reaches the following conclusions: 1. That the milk from cows affected with tuberculosis in any part of the body may contain the virus of the disease.

not.

2. That the virus is present, whether there is disease of the udder or

3. That there is no ground for the assertion that there must be a lesion of the udder before the milk can contain the infection of tuberculosis.

4. That, on the contrary, the bacilli of tuberculosis are present and active in a very large proportion of cases in the milk of cows affected with tuberculosis, but with no discoverable lesion in the udder.

PREVENTION OF CONSUMPTION.

The following from a circular distributed by the State Board of Health, of Maine, is a fair sample of what is being done by a number of the State and local boards of health towards restricting the spread of consumption.

The Restriction of Infection.-It should be impressed upon consumptive patients and other persons living with them, that the sputum (what they cough up) is dangerous and must be properly disposed of.

The sputum should be received in a spit-cup or spittoon containing a little water or disinfecting fluid, and must never be spit upon floors, carpets, or received in handkerchiefs. If a disinfecting solution is used, corrosive sublimate is unsuitable, chloride of lime is efficient, but irritates the air passages; carbolic acid (solution E.) with five per cent. of tartaric acid or hydrochloric acid, will be the best disinfectant generally available.

If occasionally it is necessary to have handkerchiefs or cloths soiled with the sputum they should be boiled as soon as possible, and before drying.

The spittoon should be of such shape that the sputum may easily fall into the water without soiling the sides of the vessel. For patients not able to sit up, a small spit-cup with a handle should be used. When flies are present, it should be covered.

Spit-cups and spittoons should be emptied and cleansed often with boiling water and potash soap. When the house has a drainage system, the contents may be poured down the water-closet or slop-hopper; when it has not, they should be buried in ground which will not be turned up soon.

The sputum should not be thrown out upon the surface of the ground near inhabitated places, nor on manure heaps, nor where animals may get it, nor where it may soil animal food.

Boxes filled with sand or sawdust should not be used. Cheap wooden or pasteboard spit-cups are now on the market, one of which may be burned daily or oftener with its contents as a convenient way of disposing of the sputa.

A pocket spit-flask of small size has been devised, which may be used away from home.

The floors, woodwork and furniture of rooms in which consumptive patients stay, should be wiped with a damp cloth, not dusted in the usual way.

The patient's clothing should be kept by itself and thoroughly boiled at the washing.

The patient should be made to understand that in neglecting these measures, he is imperiling his friends, and at the same time diminishing very much his own chances of recovery by re-infecting himself with the inhalation of his own dried and pulverized sputum.

After a death from this disease has occurred, the patient's room, clothing, and bed should be disinfected. For this purpose boil all bed and personal clothing, or disinfect them when practicable in a steam disinfector; wash furniture, woodwork, walls, and floors with carbolic acid solution (solution E), and thoroughly expose the rooms to light and air.

If raw milk is used as food, especially if it is to be given to children, an assurance should be had that the cows which produce it are perfectly healthy and subjected to healthful treatment.

When there is any doubt as to the health of the cows which furnish the supply, the milk should be boiled before use.

Thorough cooking will remove all danger of tuberculosis through the medium of the meat supply.

Tuberculous mothers and those inclined to consumption should, under no conditions, nurse their babies.

To Guard against Contracting the Disease.-By observing the rules which are expressed and suggested in the foregoing, the principal, if not all danger of infection may be avoided.

Whatever has a tendency to undermine the general health increases the susceptibility to the infection and diminishes the power of recovery from incipient tuberculosis.

A fact abundantly shown in the dissecting room is, that many persons dying of other diseases, have had tuberculosis and have recovered in its early stages.

This tendency to breathing of pure air. ventilation of inhabited rooms and churches.

recover is greatly strengthened by the habitual Means should be provided for the abundant rooms, particularly of sleeping rooms, school

The open air treatment of consumptives and those who are threatened with tuberculous disease, has given much better results than any other. Particularly in Germany, and to some extent in this country, such treatment has been systematized in "sanitaria" for consumptives. Here the patients have the advantage of a regular life, nutritious food and such exercise as they can bear without fatigue; but the chief curative agent is an abundance of fresh air. Even in the coldest of winter weather, patients, after a period of gradual habituation, and always guided by the judgment of the physician, pass the whole day walking in the open air, or sitting or lying on resting places wrapped comfortably in blankets. Usually no claim is made for advantages of climate. abundance of pure air is the all important thing.

TRICHINE IN SWINE.

An

Prof. E. L. Mark has recently published the results of the examination of 3,064 hogs raised in the vicinity of Boston, Mass. (Report State Board of Health, Mass., 1888). The examination extended over the five years, 1883 to 1888. The results show that 14.07 per cent. of the males and 10.61 of the females examined were infected with trichinæ, or 12.86 per cent. of all examined. Similar examinations of Western hogs have shown only from two to three per cent. to be infected. Prof. Mark reaches the conclusion that this difference is probably due to the character of the food given to those raised in the vicinity of Boston and presumably in the vicinity of other large cities. Of the fifty-six raisers of the hogs examined by him, fifty-one fed city offal. The source of the infection he believes to be in the uncooked meat found in kitchen garbage. It would be interesting to know the condition, in this respect, of the large number of hogs fed upon this food in and about the other large cities.

ADULTERATION OF DRUGS.

That the practice of adulteration is not confined to foods seems evident from the reports of various sanitary authorities. In the Report of the State Board of Health of Massachusetts, for 1888, we are told that of 4,592 articles examined during the last six years, 1,736, or 37.8 per cent., did not conform to the statutes. In 1886, 47.8 per cent. of the samples examined were adulterated or varied from pharmacopoeial standards. The lowest percentage of adulteration found in these years was in 1888, when 26.4 per cent. of articles examined were adulterated.

In the State of New York, during the year 1888, 505 samples of pharmacopoeial preparations were purchased on prescriptions with the following results:

Good quality, 43.8 per cent.; fair quality, 17.4 per cent.; inferior quality, 26 per cent.; not as called for, 11.6 per cent.; excessive strength, 1.2 per cent.

We mention, as examples of these examinations, the following

cases:

Seventy-two samples of ether fortior, U. S. P., showed thirty-four to be of good quality, eight of fair quality, and thirty of inferior quality.

Fifty-three samples of spiritus etheris compositus, U. S. P., were purchased. Three proved to be "sweet spirits of nitre," eight were of good quality, five of fair quality, and thirty-seven of inferior quality.

These articles were dispensed upon receipt of a physician's prescription, and therefore should have been what was called for.

PATHOLOGY.

BY J. M. VAN COTT, JR., M.D.

PATHOLOGY OF SYPHILIS OF THE POSTERIOR COLUMNS OF THE CORD.

Eisenlohr (Centralbl. f. d. med. Wissenschaft, No. 45, Nov. 9, 1889) states that, in cases of so-called tabes dorsalis in syphilitic patients, there is always a possibility of there being no typical posterior sclerosis, but degenerative lesions confined to certain definite circumscribed areas of the posterior columns, with complication of bordering portions of the lateral columns, and the so-called root-zones. His conclusions are based upon autopsy findings in two cases. The lesions in the first case were confined to the posterior aspect of the pia spinalis, the posterior columns and bordering portions of lateral columns, and rootzone of the cord; lesions of cord confined to an area of 11⁄2 c. m. at the height of the eighth dorsal vertebra. The lesions of the second case involved the pia cerebri and pia spinalis and the posterior aspect of the cord in several well-defined and circumscribed areas. both cases the clinical symptoms were almost exactly those of tabes dorsalis.

POLYPOID SARCOMA IN CHILDHOOD.

In

Kolisko (Centralbl. f. d. med. Wissenschaft, No. 45) remarks the connection between the peculiar polypoid sarcomata of the vagina of children and the papillary nature of the foetal vagina at the fifth month. Their resemblance puts him in mind of Conheim's theory of "arrested development" in the etiology of tumors.

He says the surest sign of malignancy in these tumors is their tendency to recurrence. The only hope of relief is extirpation of a very large margin of vaginal tissue around the recurrent tumor. Less radical measures will not prevent recurrence (because of the tendency to discontinuous growth). Death in fatal cases occurs either from retention of urine, peritonitis, or (more rarely) asthænia.