The Dominion. FRIDAY, FEBRUARY 19, 1909. THE WAR AGAINST TUBERCULOSIS.

Dominion, Volume 2, Issue 436, 19 February 1909, Page 4

The Dominion. FRIDAY, FEBRUARY 19, 1909. THE WAR AGAINST TUBERCULOSIS.

.' Once more ' a conference is sitting' in London to continue.,trie 'long;and,.deter ; . .mined/struggle against. tuberculosis.'Tlie constant • research/ of; thousands" of in- v '.yestigators,. the .holding of; innumerable Congresses,, and the introduction . of: organised systems of 'treating .those.'-, ing from the disease, tell a.talo of energy and progress -that .unfortunately .finds but little reflection in; the! statistics /of. mortality/from /'consumption;..' The. Conference ,^ largely with. preventiye'measurcs, a; .field in which;almost .everything is/still, to. do in Great Britain; v /How much, there is to be/ done, how enormous tho task before the scientists, can be understood when it is,/said that the natural ;history of the disease is still in controversy oh a fundamentally 'important point. The scientists have riot yct : agreed upon-tho relation be-: tweeri human .and animal .tuberculosis. In,the London Times .of: December 28 last a.history of the controversy upon this unsettled point is given in a very long article, which may bo briefly summarised; By thoyoar 1901,-/when'an im- : portant Congress assembled in London, it had been 'established that while tuberculosis in the human adult was diminish-; ing,': tuberculosis amongst children was on the increase, arid; this was connected with, the influence of milk containing the bacilli of .the disease.' At that Congross, Professor Koch .startled his audience by recounting the results of a series of experiments which '.'.convinced him .' that "huirian tuberculosis differs.from bovine, and, cannot be transriiitted to cattle,!' while the rarity of / "intestinal" tuber'-; culosis.in children led him to believe that the convorse was nearly, true aIBO. ■ Hia

final conclusion was that "the only main source of tho infection of tuberculosis is the. sputum of consumptive patients, and the measures for: the combating of tuberculosis must aim at the prevention of the dangers arising from Sits diffusion.". This view was promptly (attacked, and its soundness shaken, by many eminent men, including Lord Lister and Professor Nocard, but tho impression made by Peofessoe Koch was so strong that a Eoyal Commission was appointed to investigate the question's : involved. In an interim, report, issued in 1904, the validity of Professor. Koch's conclusions .was denied/, arid it was asserted that the. human and- animal diseases arc identical in their "broad general features" and their "finer histological details." Subsequent. reports still more emphatically proved the susceptibility, of, human beings ; to infection, from animal sources, and chiefly, of ■'" course, from infected milk. ""'.

This was the position when the. Washington Congress was held in September last,: at which Professor Koch still kept his ground by suggesting errors and deficiencies in the British Commission's experiments, and the bulk of. opinion is still persuaded that tuberculous meat or milk can kill.children by its action on the abdominal glands, and can kill thosewho. survive the abdominal attack by developing : into the ordinary form of ■• pulmonary tuberculosis.-This is a summary of the Times' article, which called forth a. reply from 'Professor Koch .last month. The '-Professor is still unconvinced. He re-assorts his firm belief that, the disease dorived from animal sources —he never denied /that.: the disease canbe thus contracted—is practically, harmless to those who..come in. contact with the victims arid he therefore thinks, that; it is wasteful to divert to, defence against bovine, tuberculosis -any of the energy, required; for the,repression of human: Consumption. Despite the emphasis and particularity of the lloyal Commission's repudiation of Peofessoe .Koch's theory,, careful writers refrain from treating,;the: question-as settled. Indeed, 'there-i are advocates '- of tho'/theory that; infection ■of; the lungs by. way of the intestinal tract is the main route,of tuberculous invasion. The ..common belief .that injected cough-spray or; sputuiri. is , the .main, almost the sole,: means by; which the: disease is' transmitted may. turn out, to be more completely'. wrong than'evch: a-liberal-mirided'supporter;bf Professor Koch would admit'to be .possible!., "It is. ■well: established," the Times points out, "that.,in consumption hospitals,;in iov{ mer years,, and b'efore.'any- special /precautions with, rogard ; to the- disinfection i'and.'-'disposal of sputa;:,were,, enforced, j. there,was littleor,no'.tendency, .on the part, of", the disease .to affect resident officials and nurses;- and .ifr is evennow,. ...held;by men,of large experience that;infection mainly , occurs\through food." in early, life, and,.that..deposits.of .tubercle' . then formed in the mesenteric or r: other glands may remain dormant . for,, -long: \ periods;, arid ultimately,'.when called/into activity by. circumstanqcs ,favoijrablo,, to' their /deveiopment.'may find their,: way 'to tho lungs .beioro'.vthey;' manifest ..their presence by:any recognisable'symptoms."' While it would .be the height ;of folly; to neglect ;,any,: reasonable,;: precautions. ..required. by. .either".theory of the disease, it :,is to bo Hoped that.the:points in..disputo ; will be -finally,, settled before many years have passed, since/it is apparent 'that if: Professor Koch is wrong in his estimate of the relative importance, of the human and bovine 'sources of infection'a-'portion. of the. large, 'sums- of'money, spent;,', on | sanatoria would-bo, far.'better spent-in stopping the attack;from the'bovine,side.