Text book of veterinary medicine, Volume 4 (of 5)

Synonyms. Definition: infectious disease caused by bacillus, attended by productive inflammation, tubercles, necrotic degeneration, caseation, fibroid change, calcification or ulceration. Animals susceptible: python, salamander, carp, fish, birds, rodents, sheep, goats, solipeds, cattle, dogs, cats, apes, swine, wild ruminants, kangaroo, carnivora, cage birds, civilized (housed) man. Geographical distribution: with dense population, Central Europe, Britain, Eastern States; little in absence of cattle products—Scottish Western Isles, Iceland, Newfoundland, Greenland Highlands, Arctic North America, Northern Norway, Sweden, Lapland: open air life protects. Virulence: ancient records, modern, early antituberculous legislation, decimation of herds, researches of Vilemin, Gerlach, Chauveau, Semmer, Parrot, Tappeiner, etc. Bacillus tuberculosis: evolutionary changes, relation to actinomyces, 1.5 to 3.5μ by 0.2μ shorter and thicker in ox, solitary, exceptionally short chains, on blood serum may be filamentous, staining slow, carbolated fuchsin, technique, sections; biology, adaptation to environment, to genera, variation in same genus, experiments showing real identity of variant forms; vitality: in water human bacillus 50 to 70 days, bovine bacillus indefinitely, avian 117 days, dried sputa 9 months, cow’s lung 102 days, putrid material 43 days to years, survives gastric juice, sunlight kills in some hours, if in thin layer, day light 7 to 18 days, dry heat (212° F.) for an hour left living bacilli, moist heat 140° F. for 1 hour kills, low temperatures (−25° F.) fail, after 15 days in salt failed in rabbit, after 30 in Guinea pig. Chemical disinfectants. Accessory causes: racial vulnerability, close buildings, dark, foul, damp stables, poor scanty food, heavy milking, conformation, early breeding, inbreeding, age, predisposing diseases, traffic in animals, dairy extension, admission of tuberculous animals from other states, assorting tuberculous for sale in a given State, sale of sound from tuberculous herd, lack of indemnity for animals killed, private testing of herds and sale of tuberculous, accustoming to tuberculin test, antipyretics during tuberculin test, false certificates of tuberculin tests, feeding hogs on tuberculous offal, feeding calves and hogs on tuberculous milk, feeding hogs after tuberculous cattle, feeding from a common trough, dry, dusty stables, extension through vermin, flies and other insects carry virus. The tubercle: miliary, pinhead, conglomerate, proliferation of cells—tissue and leucocytes, in nests in stroma, giant cells in center, then epithelioid, then lymphoid, caseation, calcification, fibrosis, pearl disease. Localization: Cattle: pulmonary: miliary tuberculosis, aggregation into larger tubercles, caseated centres, fibroid, cretified, abscesses, vomicæ, complex infections, infiltrations, difference from broncho-pneumonia, lesions of different ages; pleural lesions; congestion, exudation, fringes, nodules, grapes, adhesions, caseations: bronchial and mediastinal glands, congestion, swelling, softening, induration, caseation, cretefaction: cardiac lesions: lesions of mouth and throat, pharyngeal glands: gastro-intestinal, peritoneal, mesenteric glandular; œsophagastoma; liver tubercle; splenic; pancreatic; genito-urinary; mammary; cerebral; spinal; orbital; skeletal; cutaneous; muscular; glandular; table of distribution. Swine: lesions: pharyngeal, intestinal, mesenteric, muscular, hepatic, splenic, glandular, pulmonary, skeletal, caseation, liquefaction. Horse: lesions: thoracic, abdominal, glandular, of serosæ, vertebræ, etc. Sheep and goat: lesions: thoracic, abdominal, glandular, hepatic, pharyngeal, facial, etc., verminous affections. Dog and Cat: lesions: respiratory, abdominal, pharyngeal, tonsillar, hepatic, pancreatic, splenic, skeletal, arthritic, cutaneous. Apes and Menagerie Animals: lesions. Chickens: lesions: intestines, liver, spleen, peritoneum: lungs and kidneys often escape. Pheasant: lesions: as in hens, centre zone has epithelioid cells, fibroid, cretefaction, amyloid degeneration. Parrot: lesions: eye, beak, tongue, palate, larynx, bones, joints, lungs, liver, intestines, muscles, skin. Primary and secondary infection, extension by lymphatics, blood channels, tonsils, inhalation, deglutition.

Synonyms. Consumption; Tabes; Scrofula; Pining; Grapes; Great White Plague, etc.

Definition. An infectious disease common to man and a large number of animals, caused by the bacillus tuberculosis, and characterized by a productive inflammation giving rise to small, rounded bodies (tubercles), or diffuse infiltration, with a tendency to necrotic degeneration, and caseation, or to fibroid degeneration (sclerosis), calcification or ulceration.

Animals susceptible. Tuberculosis comes near to being a panzoötic, since although reptiles, fishes, birds and some mammals do not readily contract it under normal conditions, yet under abnormal and debilitating conditions nearly all will succumb to it.

Reptiles. Sutton found tuberculosis in a python which was kept so warm in the London Zoological Gardens that a thermometer between its folds registered 85° F. Kráhl, Battaillon and Ferre cultivated the bacillus in frogs, Kráhl in snakes. Blauvelt found tuberculosis in a salamander. Lechner found it in amphibia.

Fishes. Broussais records the prevalence of tuberculosis in carp in a pond which received the sputa of a consumptive man. Under the skin were found rounded tumors, containing abundance of bacilli, that infected rabbits and Guinea pigs on which they were inoculated.

Birds. In birds of the farmyard—hens, pheasants, turkeys, ducks and pigeons—it is very frequent and often occurs as an epizoötic. While the tuberculosis of barnyard fowl is a manifest variety and not readily interchangeable with the varieties affecting the mammal, yet, with a special predisposition, it can be transferred and can then be conveyed from animal to animal in the new genus in which it has been implanted. That of cage birds is interchangeable with that of man.

Rodents. Guinea pigs have a strong susceptibility to tuberculosis, whether from human or bovine source, and rabbits for that of birds, and by continuous transmission through the body of the rodent, all alike seem to tend toward acquiring common characters. The Guinea-pig, therefore, has been especially availed of for the experimental transmission of tuberculosis, and, as the disease in them becomes acute and rapid in its progress, these subjects permit the multiplying of experiments in a short period. Rabbits are less vulnerable to the bovine or human form.

Sheep and goats, kept under usual conditions, show a remarkable immunity from tuberculosis, yet if directly inoculated an inherent susceptibility is easily shown. Habitual immunity may be in some degree due to their open air life, to the heavy winter fleece protecting them against chills, to the comparative absence of the heavy and continuous milk yield demanded of cows, to the more restricted development of the lymph plexuses in the lungs and elsewhere, and to the limited opportunity offered by the small tonsils for infection entrance.

The horse, ass and mule rarely contract tuberculosis casually, the more spacious stall, outdoor life, hard muscular condition, the very small tonsils, the exclusive nasal respiration, the paucity of connective tissue lymph plexuses, and the abundance of red globules, probably favor immunity. Yet on inoculation by Chauveau, Nocard and others, the horse readily succumbed to infection, generalization taking place more certainly than in the ox.

Cattle. The bovine races are remarkably subject to tuberculosis. This is probably due in part to the great amount of connective tissue lymph plexus in the lungs and elsewhere, the habit of using the mouth in hurried breathing, the deep, sudden inspiration through the mouth and over the tonsils that follows a cough, the habitual restricted size of the cow stables, the absence of individual separated stalls, the habit of feeding from the same trough with the cattle adjacent, the great drain of yearly breeding and heavy milking, the retention in the herd of old, failing cows for their milk product and high priced offspring, and the bovine habit of licking each other with the infected tongue. In many European cities and even in country districts the disease is very prevalent. In Copenhagen a few years ago 17.7 per cent. of all oxen and cows killed in the abattoirs were tuberculous; in Berlin 15 per cent.; in Holland 20 per cent.; in Pomerania and Bomberg 50 per cent.; in Hildesheim, Hanover, 50 per cent.; in Berlin dairies 75 per cent. (Ostertag): in Leipsic and Edinburgh 20 per cent. The great variation in the data for the different cities is suggestive of different inspection standards. American figures as given by the Bureau of Animal Industry are for Baltimore (mostly cows recently from the country) 2.5 to 3.5 per cent.; and for the packing centers (among 2,273,547 mostly fat steers, and therefore selected) 0.02 per cent. It is here largely a matter of locality and infection, I have seen large herds with 100 per cent. tuberculous, and extensive districts, in the north and especially in the south entirely free from the disease.

Dogs and cats in their natural condition rarely show the disease, but contract it readily on inoculation. Cadiot found 40 cases in 9,000 post mortems of dogs. The young are apparently more susceptible than the old, and primary lesions in the abdomen are common and suggest infection through the food. The majority belonged to consumptive persons, and gnawed the bones that had been first picked by the owner, and ate from his plate what he left. Jacobi records the case of a dog, with general tuberculosis, which habitually licked up the expectorations of his phthisical master.

Apes and Monkeys, in confinement, almost all die of tuberculosis.

Swine contract tuberculosis readily, the large tonsils, the habit of breathing through the mouth, and the abundance of connective tissue and lymph plexuses in the lungs and elsewhere contributing to this. Yet in them the affection is mainly a dietetic disease. Swine kept in the country and fed on vegetable food are rarely affected. In Saxony, where 17 per cent. of the cattle are tuberculous only a shade over one per cent. of swine were so, and in Baden only 0.02 per cent. In hogs raised on our western farms and corn-fed the proportion is much less. Yet in those fed on uncooked skim milk, kitchen scraps and the refuse of slaughterhouses in a raw state, tuberculosis becomes very common. In one case, in a large public institution, where the dairy herd was universally affected, and where, on their slaughter, their raw offal had been thrown to the hogs, I found that the latter were almost all tuberculous. Similarly, in feeding experiments, from the time of Gerlach, pigs and especially young pigs, have shown themselves to be very susceptible.

Among the less domesticated animals that contract tuberculosis may be named deer, elk, gazelle, antelope, camel, dromedary, giraffe, kangaroo, lion, tiger, jackal, jaguar, bear, arctic fox, rat, mouse and the common cage birds, etc. Fröhner found 36 per cent. of parrots affected in Berlin.

Man has long been recognized as standing in the front rank of susceptibility to tuberculosis. Yet even in his case the prevalence of the affection bears an intimate relation to his indoor life. In large cities post mortems often show that one-third have suffered, and that one-seventh and upward of the whole population die of tuberculosis. Natives of tropical islands and countries, living in the open air and apart from close association with civilized man, often escape entirely. In South Africa the herdsmen living in close buildings suffer encreasingly, while their cattle, kept constantly in the open pasture, escape.

Geographical Distribution. The prevalence of tuberculosis shows a direct relation to the opportunity for infection rather than to climate, latitude or altitude. It is the prevailing disease of civilized communities with dense populations, and especially in large cities where the general vitality is lowered and the crowded buildings give every opportunity for infection. It is preëminently the disease of Central Europe, of Great Britain and of our Eastern States, where there is the greatest activity in business, manufacture and commerce. Yet in the Scottish Hebrides, Iceland, Newfoundland, the Greenland Highlands, Arctic North America, the northern parts of Norway and Sweden, Lapland and Finland it is hardly known. The absence of commerce and cattle and the sparse population have much to do with this. The coasts of Greenland with their Danish stations have two-thirds of the population tuberculous (Cook); the Indians of Barrow’s Straits, when infected in 1899 by the frozen-in whalers, suffered from it as from a plague; in Christiana, Stockholm and St. Petersburg it is as prevalent as in the large cities of Central Europe. Elevated and dry climates have often been found to be free from the affection, yet it prevails inside the double windows of houses in the higher Alps, and has, within a generation established a notorious prevalence in Minnesota, Dakota and westward, as it has in Australia, mainly owing to the advent of consumptives who sought for health in the dry atmosphere. The hills and dry tablelands in North and South America, Africa and Asia which have acquired a reputation for salubrity, owe this largely to the sparse population and the absence of facilities for infection. In South Africa, in spite of the dry and genial climate, the disease is constantly encreasing in the human (housed) population. The sea-coasts, which are the seats of large cities and the centres of population and trade, are also the most extensively affected with tuberculosis—in the West Indian Islands, Panama, Nicaragua, Mexico, Yucatan, Columbia, Equador, Peru, Chili, Ceylon, Guinea coast—while the sparsely peopled highlands of the same countries are practically free.

What is true of man is equally so of cattle. In the Gulf states of this country, herds living in the open air are practically free from tuberculosis, while in New Orleans and other large cities, the cows shut up in the confined stables and yards, are as tuberculous as those of the great cities of the north. So in many districts in the northern states we find no bovine tuberculosis, while in others, differing in no essential particular as regards geological formation, altitude, exposure, and industrial use of the animal, a large proportion are affected.

Virulence. Tuberculosis has long been recognized as virulent. “It is indicated in the Mishna and other Jewish works as rendering the meat unfit for consumption, but to come to more modern times, we find that throughout the seventeenth and eighteenth centuries the flesh of tuberculous animals was excluded from human food, alike by the civil and ecclesiastical laws of Europe. Tuberculosis in cattle was erroneously identified with syphilis of man, which made a frightful extension in the end of the fifteenth century, spreading from the army of Charles VIII which had been engaged in the siege of Naples. This conviction lasted until it was disproved about 1782. Though mistaken in the identity of the two diseases, the fact that for centuries the common people and physicians both associated tuberculosis with a malady so notoriously contagious as syphilis, speaks strongly for the forcible evidence of contagion manifested at that time. Morgagni, who must have begun practice about 1700 A. D., testifies to the strong conviction of the contagious element in tuberculosis. Indeed it became a common practice to isolate the consumptive person from the public, and after his death to burn his clothes and sometimes even the house, or at least to subject them to a careful disinfection. It is recorded that in 1750, in Nancy, the magistrates ordered the burning, in the public square, of the personal property of a woman who had died of phthisis, from sleeping in the bed of another consumptive person.

“At Naples, a royal edict of September 20, 1782, prescribed the sequestration of the phthisical, the disinfection of the rooms, chattels, movables, books, etc., with vinegar, eau-de-vie, lemon juice, sea-water, fumigations, etc., under a penalty of three years at the galleys, or in the case of nobles, of three years imprisonment and a fine of 300 ducats. A physician who failed to report a case of consumption was fined 300 ducats for the first offense, and banishment for ten years in case of a second. Any one assisting in such evasion of the law was sent to prison for six months.

“Chateaubriand found that, in 1803, he could not sell his carriages in Rome, because Mme. Beaumont, who had died of consumption, had ridden in them three or four times. George Sand, who was with the phthisical Chopin in Minorca in 1839, was refused a lease of the house for the second month, and the price of repainting and purifying was demanded. Later, in Barcelona, they were assessed for the bed on which Chopin had slept, as the police regulations prescribed it should be burned.

“This was not a mere survival of vulgar prejudice. Jacobi tells us of a dog which died of consumption from eating the sputa of his phthisical master. Laennec, the discoverer of auscultation, and the great authority on pulmonary consumption, records that he himself contracted a tuberculous nodule, through a wound with a saw, while making a necropsy in a case of phthisis. Laennec died of tuberculosis later, although he seemed to have checked this lesion by caustics. Andral joins Laennec in enjoining the greatest caution and cleanliness in taking care of, or associating with persons having advanced tuberculosis.

“Cullen, who started with a strong prejudice against the doctrine of contagion, leaves us the following instance of its occurrence: ‘A young man predisposed to phthisis married a Dutch girl of a sanguine temperament and good constitution. Some days after the marriage the woman lost her fresh color and was attacked by a bad cough; a month later she commenced spitting blood. The physician advised her not to sleep in the same bed with her husband, but she refused to follow his advice, and six months later she died of phthisis. The servant who took care of her and the domestic, who avoided, as far as possible, staying in the sick chamber, both died of consumption.’

“Wickmann, court physician in Hanover, in 1780, pronounces emphatically for contagion. In Zurich, at that time, one death in every six was from phthisis. The contagion of phthisis was slow in its operation, and was, therefore, less evident than that of plague, smallpox, scarlatina and other affections attended by a skin eruption, but it was no less real and deadly. It was also less frequently indirect, or carried from victim to victim by intermediate agents. He cited instances of the transmission of consumption from husband to wife and vice versa, and claimed that the marriage of a phthisical person should be legally prevented. As a means of preventing the disease, he proposed a strict surveillance of establishments for the sale of old clothes, and the avoidance of leaving infants with consumptives.

“Valsalvi and Sarconi refused to make necropsies of persons who had died of phthisis.

“Dr. Ruhling, of Gottingen, writing in 1774, of the disease in animals, says: ‘The malady is transmitted to sound animals by direct contact of animals standing side by side in the stall, and licking each other, and breathing the expired air direct from the diseased lungs; the frequenting of the same pastures will also serve to propagate it.’ In Krunitz’s encyclopedia, published in Berlin, in 1787, is the following: ‘The heifers show an ardent desire for the male, and remarkably enough, do not become pregnant, but part with the fruit of conception. When opened these animals show the first stomach, kidneys and surface of the lungs, covered with pustules like dried mulberries or in suppuration. The affection is contagious, and communicates itself from one animal to another by contact.’

“Fromage, in the Dictionaire de Rozier, Article Phthisis, says: ‘Men of art are very much in accord that this malady is not contagious, but some stock owners think differently.’

“Huzard, who saw much of tuberculosis in the Parisian dairies in the concluding decade of the last century, said that most of the veterinarians looked upon the disease as contagious, and that some of the physicians believed the same of the phthisis of man.

“Dewar, speaking of his experience in Scotland in 1839, and succeeding years, in a particular herd, says: ‘The proprietor agreed to remove partition walls, and to make openings opposite one another in the outside walls, so that there might be a current of fresh air passing through. These alterations combined with cod liver oil, tonics and stimulants, may have prolonged life but yet no cure was effected, and that herd died out. I resorted to every precaution when new cattle were purchased to prevent infection; as I had an idea, even at that time, that the disease might be communicated from one to another when in immediate contact. The precautions adopted when fresh cattle were purchased had the desired effect, for in a few years afterward, they were as good a lot of cattle as any in the district. That herd left an impression on my mind that never can be effaced, and made me always dread the evil consequences of tuberculosis. Having practiced in the same locality, which is an extensive breeding and rearing district, I have seen several herds decimated. Though I have sometimes foretold the owner what he might expect, yet he did not believe me until so many were infected that the byres were infested with the fearful malady, and your remarks in regard to nose contamination are so true that I do not think it possible any can escape that are so exposed. I have also seen, as Grad has, the same stall infecting beast after beast until a thorough cleaning and disinfecting, with plenty of fresh air had removed all infection.’

“Spinola, writing in 1858, of bovine tuberculosis, gives contagion as a possible cause, and Lafosse, in 1867, says: ‘Physicians begin in imitation of Morgagni to believe in the contagion of phthisis. The facts published by Villemin appear to support this opinion, which has been held by our colleague, Dupont, of Bordeaux, for several years.’

“Cruzel in his work of date, 1868, is much more positive; he says: ‘This fœtid expired air, inhaled immediately by another cow upon a sound lung, gives the latter tuberculous infection. It is a matter of every day experience to the veterinarian. Two oxen or cows are kept in the same stable, take their food from a common rack or manger, lie in the same stall, and respire nose to nose. The one is, to all appearances, perfectly sound, the other is in as good a condition, and is vigorous, but it coughs from time to time, and its breath is foul. Soon we notice that the animal that does not cough, eats with less appetite, he loses flesh and soon he is unequivocally affected with the same malady as the first.’ The foregoing quotations show clearly that in spite of the misleading teachings of Broussais and others, the doctrine of contagion in tuberculosis could not be overcome, and that up to the time of the remarkable experiments of Villemin, in 1865, it maintained its hold upon the minds of extensive and careful observers. In animals, especially, the evidence was so frequent and clear, animal following animal in the same stall, and eating from the same infected manger, only to be infected in turn, and two animals stalled together, and licking the same manger with their prehensile tongues, transmitting the infection with certainty the one to the other, were facts that could not possibly be ignored. Other cattle in the same building might escape for a length of time, but the eating in common from the same fatal manger, by a tuberculous and a healthy animal, quickly sealed the fate of the latter.

“Physicians, too, who were compelled to investigate the causes of the extraordinary fatality from tuberculosis in the armies and navies, could not shut their eyes to the fact notwithstanding that they came to the task strongly prejudiced through education against the acceptance of contagion. Thus, Dr. Bryson, in his report to the Epidemiological Society, in 1860, on consumption in the several ships of the English navy on the Mediterranean station, says distinctly that the disease appeared to be propagated by contagion. Dr. Parkes, quoting this in his Practical Hygiene, says: ‘It may be inferred that pus cells were largely thrown off during coughing, and floating through the air, were received into the lungs of other persons. The production of phthisis in animals confirms this view. The case of monkeys in the zoological gardens, narrated by Dr. Arnot, is a striking instance. Cows in close stables frequently die of phthisis. But not only phthisis may reasonably be considered to have one of its modes of origin in the breathing of an atmosphere contaminated by respiration, but other lung diseases, bronchitis and pneumonia, appear also to be more common under such circumstances.’

Villemin in 1865, published his investigations in which he had produced tuberculosis in a great number of animals, by inserting particles of fresh tubercle or injecting the tuberculous sputa of man into the subcutaneous connective tissues, the peritoneum and the trachea. There resulted in nearly every case a chronic disease, the marked phenomena of which were caseated centers devolving from firm inflammatory nodules in the seat of inoculation, in the adjacent lymphatic glands, in the lungs, serous membrane, liver, spleen and kidneys. The centers of such nodules were at first transparent and grayish, but soon the center underwent necrobiosis, forming a soft cheesy mass the size of a pin’s head, and gradually enlarging to that of a pea, a bean, a hazel nut or larger. After a period of about 14 days the lymphatic gland nearest the seat of injection could be felt as a firm pea-like nodule, and in two weeks more a second gland on the line of the lymph circulation, had become enlarged and nodular, while the first, now the size of a large bean, had probably undergone distinct softening. This became adherent to the skin, burst and discharged continuously or at intervals with little or no tendency to heal. If killed at this date, the animal showed only the open sore and a chain of nodular pea-like caseated lymphatic glands leading up from it. The lungs might be apparently sound, but the spleen and liver usually showed miliary elevations on the surface, with clear grayish centers, as viewed under a magnifying glass, opaque patches were found on the omentum, and the lymphatic glands of the mesentery, of the portal fissures of the liver and of the Hilus of the spleen were distinctly enlarged and resistant. If not killed, the subject usually died 100 to 120 days after inoculation, and then the lungs were found studded with tubercles miliary or larger and more or less caseated; the bronchial mediastinal, subdorsal, pectoral, prepectoral, phrenic, mesenteric, hepatic, and splenic lymphatic glands were more or less enlarged and caseated, while the liver and spleen were enlarged and studded with multiple tubercles. Guinea pigs give the most extensive and intensive lesions, rabbits much less so, but in both emaciation and wasting are very marked. In short the lesions are essentially and unmistakably those of generalized tuberculosis.

“At first, however, incredulity prevailed and experiments on a large scale were inaugurated all over Europe and America to put the question to crucial test. Martin, Conheim, Burdon-Sanderson, Simon, Wilson, Fox, Lebert and Wyss, Fraënkel, Waldenbourg, and others inoculated with all sorts of non-tuberculous organic materials (bronchial mucus, foul pus, cancer juice, diseased liver, simple cotton setons, etc.) and from these in Guinea pigs there resulted local caseated foci, and implication of the adjacent lymphatic glands. It was found that the liquids from low types of pneumonia produced these apparently tubercular deposits, while that from acute sthenic pneumonia did not; that the cotton thread seton failed to produce the disease if it were first steeped in carbolic acid, and that the lesion caused by breaking a bone without injury to the skin failed to produce the characteristic lesions even in the very susceptible Guinea pig. It became evident, therefore, that the morbid results in these cases, were due to accidental inoculations with the poison of the tubercle, which is widely distributed, or with some pyæmic or other germs.

“Gradually the truth triumphed, and those who had at first been loudest in their opposition were led by their own experiments to become the firmest supporters of the new truth.

“As early as 1874, Gerlach had experimented largely in feeding the milk of tuberculous cows, and had infected calves, pigs, sheep and rabbits in this way. Chauveau in (1874), Klebs (1873), Semmer (1880) and Parrot (1870) fed calves, cats, Guinea pigs, pigs, sheep and a variety of other species of animals with tuberculous flesh or lungs, or saliva, producing tuberculosis in a large proportion of cases. In this manner they escaped the charge of the operation of a wound and of ærial bacteria, and yet succeeded in producing infection. The lesions in this case began in the intestinal mucous membranes and mesenteric glands.

“Another essay in the same direction was made by Tappeiner (1878), who infected rabbits, Guinea pigs and dogs, by enclosing them in boxes and compelling them to breathe tuberculous liquids intimately mixed with the air atomization. In these cases lesions began in the lungs and bronchial and mediastinal glands.^[1]”

Bacteriology. The bacillus tuberculosis, the essential cause of tubercle, was demonstrated by Koch in 1882. It was at first supposed to be peculiar in its indisposition and tardiness to take a stain, and in its retention of the stain once imparted, even when it is treated with acids. Later observations have shown that these characteristics are common to certain other bacilli, notably to those of leprosy, smegma, and to specimens found in timothy hay and other grasses, cow dung, milk and butter. These furnish sources of fallacy in the milk and butter especially, but when the specimens examined are taken from the interior of a tubercle, lymph gland or serous cavity the danger of error may be practically ignored. What is quite as important is the fact that the tubercle bacillus is subject to evolutionary changes in adapting itself to a habitat in different genera of animals, and to a lesser extent in different parts of the same animal, by which its pathogenesis is modified, but these variations do not materially affect the staining qualities. Still more striking variations have been found in old cultures, ovoid forms (Metchinkoff), club-shaped microbes and filaments (Metchinkoff, Klein, etc.), branching filaments (Fischl, Coppen Jones), divergent club-shaped groups, like actinomyces (Babes and Levaditi). The last named, seen in inoculated rabbits, have been held to establish a relationship between the microbes of tuberculosis and actinomycosis, as the club-shaped cells do not take the usual Ziehl-Neelsen stain for tubercle bacilli, but the Birsch-Hirshfeld’s actinomyces stain. Apart from the rabbit such variations are not likely to prove sources of fallacy in identification of the microbe.

Morphology. As met with in the tubercle of man or ox the bacillus is a minute rod with rounded ends, 1.5 to 3.5μ long, by 0.2μ in thickness. In the ox it is shorter and thicker on an average than in man. They are usually solitary, but two and exceptionally even three or four elements may be united. In stained specimens unstained portions are frequently seen (spores?). When cultivated on blood serum there is a tendency to form elongated rope-like colonies having a waving outline. Other evolution forms have been already noted.

Staining. The resistance to staining is overcome by a heated alkaline watery solution of methylene blue (Koch), or better by a carbolated solution of fuchsin (Ziehl-Neelsen). To a 5 per cent. watery solution of carbolic acid add one tenth of its volume of saturated alcoholic solution of fuchsin. The suspected sputum or scraping from a section of a lesion is spread in a thin layer on a cover glass by drawing over it the straight edge of a second cover glass, dried in the air, and passed three times through an alcohol flame with the smeared side up. It may then be floated on the surface of the staining fluid with the specimen side down, then gently heated for three or four minutes almost to ebulition, drying being prevented by the addition of more of the carbol-fuchsin solution as required. It is then washed in water to remove excess of the staining fluid and treated with a bleaching acid solution (sulphuric acid 5 per cent. or nitric acid 15 per cent.) When decolorized it is well rinsed in two or more portions of a 60 or 70 per cent. alcohol and then in water. Next stain with a 1 or 2 per cent. aqueous solution of methylene blue for one minute and wash off the excess with water. The tubercle bacilli will appear of a deep red and other bacteria blue.

Gabbett’s counter-staining and decolorizing solution is especially useful in economizing time. After staining, as above directed, in the carbol-fuchsin solution for one minute, wash in water, then cover with a solution of 2 grams methylene blue (powder) in 100cc. of 10 per cent. sulphuric acid, until the film has a faintly bluish tint: then wash thoroughly in water and examine. Tubercle bacilli come out red, others blue.

In examination of tissues the microscopic sections are steeped for twenty-four hours in the carbol-fuchsin solution (or 1 hour at a temperature of 45° to 50° C.), then decolorized in a 5 per cent. sulphuric acid for a few seconds, then in a 70 per cent. alcohol: they are then counter-stained in an aqueous solution of methylene blue, washed in water dehydrated with absolute alcohol, cleared up in xyol or oil of cedar, and mounted in Canada balsam.

Biology. The bacillus tuberculosis is notorious for its variant forms, assumed in adapting itself to given environments, and which it retains with considerable tenacity for a time, even when placed in a new and different medium. It is largely held to be an obligatory parasite, and incapable of survival as a saprophyte, yet Straus, Nocard and others, have shown that the form obtained from the tuberculosis of birds can easily be made to live in suitable dead mixtures of organic matter. It is also notorious that the bacillus taken direct from the tubercle of the mammal, and which, as a rule, fails to grow at once in glycerined bouillon, yet, after a first successful culture in the new medium, often adapts itself completely, and thereafter it can in many cases be transferred from bouillon to bouillon, with as great certainty as it could formerly be inoculated from ox to ox. The difference is one of habit and adaptability, rather than any primary and permanent distinction of species. There is every reason to believe that the microbe has lived, and under given conditions can still be made to live as a saprophyte, with a greatly reduced adaptability to parasitic life in the animal, just as we see to-day that it is only with great difficulty transferred from certain genera of animals to certain other genera (from bird to ox and vice versa). Trudeau tells us of a culture of a bacillus tuberculosis from man, inoculated on the rabbit and then cultivated in vitro in successive generations for six years, that was in this way robbed of its pathogenesis for Guinea pigs, which, after inoculation, lived for many months, some two and a half years, and some even recovered. The average duration of life in the Guinea pig, after tuberculosis inoculation from man, rabbit, Guinea pig or recent culture is but seventeen days. The bacillus of human sputum often produces only localized tuberculosis in the ox. Even in the same species and individual the pathogenesis often varies materially. Nothing is more familiar than the slow progress of tuberculosis in the bones and lymph glands of man, on the one hand, and its frequently rapid progress in the lungs, liver and brain, on the other. As inoculated on the lower animals bacilli from the lungs of man are usually more virulent than those from the lymph glands (Creighton, Arloing, F. Craven Moore, Courmont and Denis). Among seven specimens of human sputum, the bacilli in six cases showed a fair average vitality, whereas those of the seventh failed to grow on blood serum of the dog (Theobald Smith). In both man and cow a large proportion of cases of tuberculosis remain localized, the disease lasting for years with little or no appreciable advancement, and not a few subjects appear to make a permanent recovery.

On every hand this evolutionary tendency of the bacillus tuberculosis places itself in evidence, demanding a recognition of the fact, that more or less transient or lasting variations in accordance with previous or existing environment, control to a large extent the transmissibility of the disease among different genera and even among individuals of the same genera and species, and also the fatal progress, or the mild and evanescent issue of the infection.

Even the most widely divergent of these evolutionary forms can often be made to approach each other and apparently merge into one type. Profiting by the example of Metchnikoff, Nocard enclosed in collodion capsules the bacilli of the human sputum and inserted the capsules into the peritoneal cavity of chickens which had proved refractory to their direct inoculation. This excluded the direct action of the leucocytes from the encapsuled bacilli, but allowed the endosmosis of the serum of the fowl for their nourishment. After a sojourn of four months or more they were transferred to other capsules and again enclosed in the peritoneum and after a second and third transference of this kind it was found that the bacillus had become actively pathogenic for the chicken, having acquired the infecting potencies of the bacillus of avian tuberculosis.

In keeping with the above is the fact that both rabbit and horse are easily infected by the bacillus obtained from birds, and that after a certain number of transmissions through the rabbit the issue of the bacilli of bird and mammal appear to become identical. No less instructive are the cases of the infection of carp by human sputa and the conveyance of tuberculosis to rabbits and Guinea pigs by inoculation with the nodules of the infected carp.

The vitality of bacillus tuberculosis is strong but variable. In sterilized water at 46° to 64° F. the human bacillus survived for fifty to seventy days (Chantemesse and Vidal), the bovine indefinitely (Galtier) and the avian bacillus at a higher temperature one hundred and seventeen days (Straus and DeBarry). In dried expectoration the bacillus of man still infects after nine or ten months (Koch, Schill, Fischer, De Thoma). In infected cow’s lung, dried and pulverized, it infected Guinea pigs at 102 days (Cadeac and Malet). In putrid matter it infected after 43 days (Schill, Fischer), 167 days (Cadeac and Malet), several years in a grave (Schottelius).

It is not destroyed by gastric juice (Fischer, Falk). The bacillus from tubercle of birds has a much greater vitality than that of mammals. Marfucci successfully seeded new media from a culture of two years old, and cultures in artificial media can be started more successfully.

Full sunlight renders sputum on a solid nonabsorbent surface noninfecting in several hours, varying according to the thickness of the layer (Koch, Straus). When sputum is mixed in soil it may survive until the 137th day (Feltz). On woolen cloth it may live five hours (Migneco).

Diffuse daylight, with shading from the sun, killed in seven days (Koch), to eighteen days (Lucibelli).

X-Rays do not arrest the growth of cultures (Blaikie, Pott, Ausset).

A dry temperature of 212° F. for an hour left some of the bacilli still infecting to Guinea pigs (Lartigan).

A moist heat of 140° F. for one hour sterilizes (De Man, Th. Smith, etc.). The scum formed on the milk may still prove infecting (Th. Smith). Half an hour of a moist temperature of 212° F. is sterilizing. Yet in the case of steaks, roasts and boiled meats the size of the piece often prevents the reaching of this temperature throughout, and it becomes unsafe to use any meat in which the redness of the juice shows, that the albumen has not all been fully coagulated (162° F.).

A freezing temperature, −16° to −26° F., does not devitalize the bacilli, even when alternated with thawing at intervals for several weeks (Galtier, Cadeac and Malet).

Heavy salting of meats has been thought to kill the bacillus in a month. After 15 days in salt the microbe failed to kill rabbits, but still killed the Guinea pig, whereas after 30 days it killed neither (Galtier). The fact that salted meats are always unequally impregnated in different parts, renders this extremely unreliable and more of a snare than a guide.

The action of chemical disinfectants varies not only with the agent but also with the medium in which the bacillus is found. In simple liquid media (bouillon) the following results were obtained:

The following agents proved ineffective: Saturated aqueous solution of creosote, or of B-naphthol, of naphthalin, of potassium iodide, of potassium bromide:—bromine water, iodine water (1:500), iodoform solution or vapor, vapor of oil of turpentine.

ACCESSORY CAUSES OF TUBERCULOSIS IN ANIMALS.

While recognizing that in the absence of the tubercle bacillus there can be no tuberculosis yet we must not ignore the fact that many conditions of the animal system and its environment contribute largely to the propagation of the disease on the one hand, or to hinder its progress on the other. None of these conditions can call the germ into being de novo, but in its presence, they greatly favor its diffusion or even its malignancy. Like any other seed, this bacillus requires a suitable soil and favorable climate, to bring out its most destructive development. In striking the balance, we have to guard against the error of so many, who would attribute to the germ alone the deadly results and who assume that these should be the same under all conditions, and the opposite error no less prevalent, that ascribes the evil to the conditions, and holds that without these the germ would be harmless.

Hereditary Predisposition. Racial Vulnerability. Before the discovery of the specific bacillus, when as yet tuberculosis was held to result from a constitutional weakness, or cachexia in which deterioration of cells was held to be the main factor, the disease was held to be mainly hereditary, and its every day transmission in the line of descent, and the increasing mortality to extinction of given families were confidently appealed to in support of the doctrine. Now, however, we recognize that congenital tuberculosis in man or beast is very exceptional, and that the morbid process almost invariably takes its start from the germ implanted after birth. In Saxony when the tuberculous cows were 16.5 per cent. tuberculous calves were but .2 per cent., though the latter had been fattened on the milk of the former. In Munich but two calves were found tuberculous in 400,000 killed, and in Lyons but five in a similar number. Up to the present the number of calves recorded as tuberculous at birth does not exceed seventy.

That the young almost always contracted the disease, only after birth, virtually disposes of the alleged heredity of the tuberculosis but it by no means antagonizes the heredity of the racial vulnerability. As man, cattle, swine and Guinea pigs show a much greater vulnerability than the carnivora in general, so certain families in each of these genera show a more decided susceptibility to tuberculosis under similar conditions than do certain other families. This goes far to explain the appearance of tuberculosis, in certain lines of blood, and its advance to the extinction of the family, while under no better environment, other families can count on a practical immunity. In the Burden herd of Jerseys in 1877, I condemned eleven animals, verifying my diagnosis by necropsies, and found to my surprise that I had taken every representative, even the grades, of a given family, and left all the pure bred members of a second family untouched. Both families had mingled freely in the pastures and yards, yet the second family furnished no cases of tuberculosis then nor for many years afterward. The case is all the more striking that the non-tuberculous family gave the largest yield of milk and might have been expected to run down rather than the other on account of this drain.

Close Buildings. Lack of Ventilation. Air rendered impure by being breathed again and again, predisposes strongly to tuberculosis, and has been even looked upon as the sole cause (Macormac). Everywhere city dairy cows, kept in confined, close buildings, suffer severely (6 to 20 per cent. and upward); in Berlin 75 per cent. (Ostertag); in Denmark 61 per cent. (Bang), while in the same districts country cows are comparatively immune (often 1 to 2 per cent.), and steers raised in the open air still less (0.02 per cent. for our Plains cattle). For the slighter cases of tuberculosis in man and beast, life in a pure open air, day and night, in a genial climate, gives the best hope of improvement or recovery. In the Burden Jersey herd above referred to, animals condemned in spring as tuberculous, were turned out to pasture during the summer where they maintained an appearance of robust health, yet when returned to the barns in fall they fell off rapidly, so that some had to be helped to rise in the stall. “The stabled cow, the tame rabbit, the monkey, the caged lion, tiger or elephant are almost invariably cut off by scrofulous affection” (Aitken). It has long been noticed that sailors sleeping in close spaces (Bryson, Parkes), soldiers confined to close stone barracks even in the tropics (Parkes), suffer much more than the officers in more spacious rooms (Clark). Monks and nuns (two-thirds of the deaths, Leudet) occupying confined cells, and the inmates of prisons (four times the average outside, Baer) have shown an extraordinary prevalence of tuberculosis and attendant mortality. While this can be attributed mainly to the preservation and concentration of the bacillus in such places, a considerable allowance must be made for the impure and rebreathed air.

Dark, Foul, Damp Stables. Dark stables are usually close, dirty and damp as well, and all these conditions alike conduce to tuberculosis. Darkness hinders the development of organic coloring matter in living bodies, whether chlorophyll in plants or hæmoglobin in the blood of animals. Hæmoglobin is the main oxygen carrier in the blood, and in case of its deficiency the tissues are not properly ærated. The result is as if the inhaled air contained little oxygen, so that darkness further intensifies the evil of rebreathed, deoxygenated air. The extraordinary mortality from tubercle among prisoners, monks, nuns and miners serves to further accentuate this conclusion.

Trudeau’s experiment with rabbits is instructive in this connection. Of a number inoculated with the same number of tubercle bacilli, one half were kept in the open air and the rest in a dark, damp, underground place deprived of sunlight. When killed on the same day, it was found that the open air rabbits showed only slight lesions or none, while the underground lot had extensive tuberculosis.

The impure stable air lowers the vital tone of the animal, especially if the impurity has come from animal exhalations.

The same is true of damp air, “a damp ship is an unhealthy one,” and Bowditch and Buchanan pointed out the especial prevalence of tubercle in cold, damp, undrained, foggy localities. This does not hold for all damp lands, yet damp, fog, and cold are especially hurtful in presence of the germ.

INSUFFICIENT OR UNWHOLESOME FOOD.

Starvation and indigestible or innutritious food contribute to debility, and lessen the power of resistance. Hence in the poor, half starved denizens of city slums, and among neglected herds of cattle, tuberculosis, once introduced, makes rapid and extensive ravages. Conversely overfeeding often acts in the same way, developing indigestion and thereby robbing the tissues of their proper nourishment.

HEAVY MILKING.

In dairy cows, of milking breeds, the drain on the system is liable to prove too great, under a ration-for-milk, warm sloppy mashes of grains, bran, middlings, roots, distillery swill, exclusive diet of silage, saccharine roots, or marc, warm drinking water, a warm atmosphere, liberal salting, and enforced idleness in the stall, with careful stripping of the bag. The butter cows, (Jerseys, Guernseys, Alderneys, etc.) are especially liable to suffer, as the greater the yield the more the system is robbed of the adipose material which is so needful to a vigorous health. When the cow has been reduced to a high-pressure milk factory her physical size reduced to obviate the need of a large sustaining ration, and her milking capacity stimulated to the highest degree, the presence of the tubercle bacillus is especially dangerous.

CONFORMATION.

It was formerly held that cows with heads narrow between the horns, small thin necks, narrow chests defective also in depth and length, loose projecting shoulders and elbows, pendent, pot bellies, with hollow flanks, and a general laxity of the frame were especially predisposed to tubercle. In many such cases the suspected animal was already the victim of the affection, which had brought out these characteristic features of weakness and emaciation. In other cases the unthrifty appearance was due to poor feeding and care or to chronic disease, which in robbing the system of vigor and hardihood laid it open to the attack of the tubercle bacillus whenever it was introduced. Even when there was no such depressing influence affecting the individual, the inheritance of such a frame, betokened a constitution lacking in vigor, and with little power of resistance to the invading microbe. Some milking breeds which tend to the above conformation, show an unusual development of the lymph glands and plexuses, and as tuberculosis attacks the lymphatic system preëminently, the bacillus finds an especially favorable field for development in such systems. It would, however, be an error to assume that the compact, rounded frame, with circular chest and abdomen, and full, firm neck and shoulders, with a great disposition to fat and little to milk, is in any degree immune. Under the presence of the tubercle bacillus, and close stabling, they often succumb quite as rapidly as the most susceptible milking breeds. The meat producing breeds with a strong propensity to fatten, have an extraordinary development of lymph spaces and plexus in the intermuscular and subcutaneous connective tissue, and the microbe finds a welcome home in their sluggish, inactive and atonic systems as well as in the typical dairy cows.

BREEDING TOO YOUNG.

Breeding from immature animals undermines the vitality as the system is overtaxed to sustain at once the demands for further growth, for the nourishment of the unborn offspring, and for the yield of milk. Some families of Jerseys have been undoubtedly injured in this way, through the desire to diminish the size of the cow, and yet retain the highest milk and butter yield.

CLOSE BREEDING.

Inbred families are proverbially subject to tuberculosis. By pairing individuals that show in a marked degree the desired qualities of early maturity, heavy milking, or fattening, the greatest stimulus is given to the enhancement of such qualities, and with this there is the correspondingly ready receptiveness to the tubercle bacillus. To this is added a degree of constitutional delicacy which comes from too close breeding, and which otherwise shows itself in an encreasing infertility, when bred with an animal that is nearly related. In addition, the high bred animal is kept much indoors, where the bacillus, once introduced, is easily preserved and propagated, and is denied the free outdoor life and exercise which might develop muscle and vigor. This is no valid argument for introducing inferior blood to the deterioration of the economic value of a race, but rather for the complete exclusion of the bacillus which may find in our treasured herd an especially inviting field for its ravages.

AGE.

In both man and beast, age appears to have a predisposing effect, but apart from debility or trauma, this may be fully explained on the ground of often repeated infection, an indoor life, and, in dairy cows, the excessive drain upon the system. In thoroughbred herds of cattle, in which the cows are preserved as long as they will breed, and in dairies where they are kept as long as the milk yield is satisfactory, the oldest show by far the largest percentage tuberculous. In secluded individual dairies we have found 100 per cent. affected, Ostertag gives the average for Berlin at 75 per cent., and Bang for Denmark at 69 per cent.

PREDISPONENT DISEASES.

As already noted all diseases which undermine the health tend to diminish the powers of resistance to the tubercle bacillus. To be especially dreaded, are long standing diseases which produce emaciation and debility, fevers that for a length of time impair sanguification, metabolism and nutrition, diseases of the digestive organs which cut off the requisite supply of nutritive material, and, above all, diseases of the lungs and air passages that impair the tone of the tissues and invite the attack of the invading microbe. Bronchitis, laryngitis, pharyngitis and tonsilitis in all their varied forms are to be particularly noted. Even in man it is believed that one of the most common channels of infection entrance is through the open tonsillar crypts, and the same doubtless is true of animals. Pigs, with their large tonsils and frequent infection through feeding, are probable examples of this, and when, in addition to the detention of the microbe in the cavities, there is an inflammation and debility of the tissues, the opportunity for infection is greatly enhanced.

ENCREASED TRAFFIC IN (TUBERCULOUS) ANIMALS. DAIRY EXTENSION.

In common with all infectious diseases, tuberculosis owes its great extensions to the sale and purchase of animals. Where an indigenous race of cattle is raised and sold, without any additions from without, tuberculosis is usually rare and confined to the one herd, or to those having intimate intercommunication with it. Where, on the other hand, a large stock is kept up, as in milk dairies, and few or no calves are raised, but the bulk of the cows are sold off yearly and replaced by new purchases, tuberculosis, sooner or later, finds admittance through the body of an infected animal, and once implanted in the herd, it goes on encreasing, without limitation, except by the sale or death of the more seriously affected. The larger the herd and the greater the number of yearly changes, the greater the number of opportunities for the introduction of an infecting animal. Where a great part of the herd is turned off yearly, and the new animals are drawn from any or every source indiscriminately, it would border on the miraculous if such a herd were to remain free from the infection for any great length of time. The recent extension of tuberculosis in herds has been coincident with the great development of commerce in live stock, and the rapid transit on land and water by steam. Before the days of the steam engine, animal plagues advanced slowly and uncertainly, excepting in the presence of a great European war, which drew animals from all available sources, congregating them in large mutually infecting droves in commisariat parks, and marching them in the wake of the army for its daily supply. Inevitably every country invaded was infected, and the plagues spread from the line of march in all directions. The more deadly plagues, like rinderpest and lung plague, were the first to appear, and in this lay a certain measure of palliation of the evil, as the exposed and often weaker animals were killed off, so that the slower contagion like that of tuberculosis had not time to develop. This mitigating influence held good so long as the deadly plagues were not placed under effective control. When, however, a nation successfully extirpated and excluded lung plague and rinderpest, the way was opened for a freer extension of tardily developing plagues like tuberculosis. The great development of beet sugar factories and the accumulation of herds to consume the marc; the extraordinary extension of manufactures which have made England and certain countries of Western Europe consuming rather than agricultural lands, and the wonderful modern expansion of dairy husbandry have combined to encrease and concentrate the cattle industry in ratio with the manufacturing and commercial progress of the nations, and as the live stock are kept under a milk-stimulating regimen and a life passed largely indoors, the way has been open for an ever-advancing encrease of tuberculosis. In the United States the centralization of population in the Eastern States and in all great centres of industry and the concentration of cows for the milk supply, and in certain districts in connection with butter and cheese factories, have contributed to wide local extensions of consumption. Hence it has been no uncommon thing to find herds in the vicinity of cities with 20 to 100 per cent. affected, in striking contrast with the 0.02 per cent. found in the fat cattle from the plains.

The modern railway traffic brings to all these swarming centres of animal industry, live cattle from long distances to supply the constant depletion through deaths and the disposal of dry cows, and thus the whole Atlantic slope is drawn upon to fill the eastern stalls. Infected animals thus shipped from Ohio, Indiana, Illinois, Wisconsin and Michigan for the good of the herds in those states find new homes in New York, or New England, where they have four to twelve mouths to propagate the infection before they are themselves disposed of. As in the days of the lung plague in America, the eastward trend of bovine traffic, becomes to a certain extent a protection and benefit to the herds of the west, but in equal ratio it operates to the detriment of our eastern stock. What is true of the planting of new centres of infection in the busy dairy districts of the east, and of the steady increase of disease in already infected herds, through the constant addition of new cases purchased, is no less true of the corresponding districts devoted to dairying interests in the west. It is the natural order of things, that, everywhere, the new accessions of infection, coming in the lines of trade, into large dairy herds, kept to a great extent indoors for months at a time, must hasten the general infection of such herds. When, therefore, no intelligent measures are interposed to check the evil, we must expect that the marked increase in the prevalence of tuberculosis, which we have witnessed of late years, shall become more and more evident year by year. Journals have claimed credit for befriending the stockman, in opposing all control of the cattle traffic, dealers have denounced all control as ruinously oppressive and injurious, and legislators have turned a deaf ear to the warnings of science and experience, but time, in this as in all other plagues, will justify the demand for an intelligent control, and the increasing losses will one day open the eyes of the stockowners to the fact that their truest friends are those that would exclude the baneful seed, and kill it ere it has had time to germinate and bring forth its ever increasing harvests.

In the absence of any systematic and efficient government protection in this line, the stock owner can only protect his sound herd by the rigid exclusion of all animals that are not of his own breeding, or in case of purchase, by an exhaustive inquiry as to the occurrence of sickness or deaths in the herd from which he buys, and by the professional examination and test of every animal to be bought. Even then he must promptly separate, test, and, if necessary destroy any animal that proves unthrifty, or which by cough, diarrhœa, wheezing or other sign gives evidence of probable tuberculosis.

Unregulated Traffic in Tuberculous Animals from Other States. The danger of buying animals untested is in no degree lessened when they are sent in from other states. While some make a business of supplying the store market with what they believe to be good stock, there is always the temptation to turn off animals that are unthrifty or poor milkers and which have proved less profitable than the others. Some even have the herd tested and sell off those that show evidence of tuberculosis. Unless, therefore, it is held in check by the tuberculin test, the traffic is made to the extent of such sales a direct means of disseminating tuberculosis.