The essentials of the sanitarium treat ment are: A continuous supply of fresh air with no unnatural changes of tem perature and the avoidance of all sources of irritation from dust and the like; good, nourishing food in sufficient quan tity to establish and to maintain the normal body-weight of the patient; an absolutely regular life, so arranged that neither the lungs nor any portion of the body are allowed to be put to any strain; and graduated exercise without strain. A. Latham (Lancet, Aug. 16, 1902).
Prophylaxis.—Prophylaxis is • difficult in this disease, for the predisposing fac tors are numerous and often hidden. Marriage-laws prohibiting the union of physically debilitated persons would be of value, but at present are cable. Careful oversight of weakly chil dren, or apparently healthy offspring of parents of suspicious physical ancestry. especially at certain periods of life, would do much toward removing the possibility of the inception of the bercle bacillus. The children in the common school should be taught, and the public should be educated ciently, by means of tracts and circulars on the laws of hygiene and infection to enable them to protect their immediate persons and homes. Once having been taught these laws, the public should be forced to observe them.
It is generally assumed that among the sources of tuberculous infection is the transmission of the germs of the disease from tuberculous animals to. man. In order to decide this question. experiments were personally carried out. during the last two years with Pro fessor Schutz, of the Veterinary College in Berlin. A number of young cattle which had stood the tuberculin test, and might, therefore, be regarded as free front tuberculosis, were infected in vari ous ways with pure cultures of tubercle bacilli taken from cases of human tuber culosis; sonic of them got the tubercu lous sputum of consumptive patients direct. In some cases the tubercle ba cilli or the sputum were injected under the skin, in others into the peritoneal cavity, in others into the jugular vein. fix animals were fed with tuberculous sputum almost daily for seven or eight months; four repeatedly inhaled great quantities of bacilli. which were distrib uted in water and scattered with it in the form of spray. None of these cattle (there were nineteen of them) showed any symptoms of disease, and they gained considerably in weight. From six to eight months after the beginning of the experiments they were killed. In their internal organs not a trace of tu berculosis was found. Only at the places where the injections had been made small suppurative foci had formed, in which few tubercle bacilli could be found. This is exactly what one finds when one injects dead tubercle bacilli under the skin of animals liable to contagion. So
the animals experimented on were af fected by the living bacilli of human tuberculosis exactly as they would have been by dead ones: they were absolutely insusceptible to them.
The result was utterly different, how ever, when the saute experiment was made on cattle free from tuberculosis with tubercle bacilli that came from the lungs of an animal suffering from bovine tuberculosis. After an incubation period of about a week the severest tuberculous disorders of the internal organs broke out in all the infected animals. It was all one whether the infecting matter had been injected only under the skin or into the peritoneal or the vascular system.
High fever set in, and the animals be came weak and lean; some of them died after a month and a half to two months; others were killed in a miserably sick condition after three months. After death extensive tuberculous infiltrations were found at the place where the injec tions had been made, and in the neigh boring lymphatic glands, and also far advanced alterations of time internal or gans, especially the lungs and the spleen. In the cases in which the injection had been made into the peritoneal cavity, the tuberculous growths, which are so char acteristic of bovine tuberculosis, were found on the omentum and peritoneum. In short, the cattle proved just as sus ceptible to infection by the bacillus of bovine tuberculosis as they had proved insusceptible to infection by the bacillus of human tuberculosis.
An almost equally striking distinction between human and bovine tuberculosis was brought to light by a feeding ex periment with swine. Six young swine were fed daily for three months with the tuberculous sputum of consumptive patients. Six other swine received ba cilli of bovine tuberculosis with their food daily for the same period. The animals that were fed with the sputum remained healthy and grew lustily, whereas those that were fed with the bacilli of bovine tuberculosis soon be came sickly, were stunted in their growth, and half of them died. After three months and a half the surviving swine were all killed and examined. Among the animals that had been fed with suptum no trace of tuberculosis was found, except here and there little nodules in the lymphatic glands of the neck, and in one ease a few gray nodules in the lungs. The animals, on the other band, which had eaten bacilli of bovine tuberculosis had, without exception (just as in the cattle experiment), se vere tuberculous diseases, especially tuberculous infiltration of the greatly enlarged lymphatic glands of the neck, and of the mesenteric glands, and also extensive tuberculosis of the lungs and the spleen.