A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
History
A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
Medicine -- Practice
Villemin's observations have been repeatedly confirmed and extended;
although subjected to the severest criticism and control, their
results are so constant that the law of the inoculability of tubercle
is almost universally regarded as fixed. Its value as a test is
evident from the statement of Cohnheim,[54] who regards as tuberculous
only that which produces tuberculosis when transferred to suitable
animals. The transfer may be made in various ways. Chauveau and others
were successful in producing an intestinal tuberculosis by the
introduction of tuberculous material into the intestinal canal of
animals, especially the Herbivora. Tappeiner[55] succeeded in
producing pulmonary tuberculosis, with or without general
tuberculosis, in dogs, by compelling them to breathe air in which were
contained minute particles of sputa from tuberculous pulmonary
cavities.
[Footnote 54: _Die Tuberkulose vom Standpunkte der Infections-Lehre_,
1880, 13.]
[Footnote 55: _Virchow's Archiv_, 1878, lxxiv. 393.]
The production of a tuberculosis of the iris, as well as of remote
organs, by the inoculation of tuberculous material into the anterior
chamber of the eye, was an ingenious method devised by Cohnheim and
Salomonsen.[56] It permitted the direct observation of the several
steps in the process of absorption of the inoculated material and
development of the tubercles.
[Footnote 56: Cohnheim's _Vorlesungen über Allgemeine Pathologie_, 2te
Auflage, 1882, i. 707.]
The objections to the various experiments above alluded to are based
upon the assumption that the results of the inoculation are not
tubercles, but inflammatory products resembling tubercles. It is
further advocated that the inoculation of indifferent material, as
bits of glass or hairs, as well as other foreign substances, will
produce the so-called artificial tuberculosis, especially in rabbits
and guinea-pigs. It is admitted that these animals readily become
tuberculous when exposed to simple inflammatory irritants, the local
action of which frequently results in the production of cheesy
material. This termination is now regarded as due to faults in the
method of experimentation, the animals not being thoroughly protected
from the influence of the virus of tuberculosis.
The objection on the ground of structure loses its force in connection
with the well known differences in the structure of miliary tubercles
in the human body, already mentioned. The tubercles resulting from
inoculation often resemble in structure the meningeal tubercles of the
brain rather than the type presented by tubercles in lymphatic glands.
The development of tubercles in the iris may take place without any
permanent inflammatory reaction. The association of evidences of
inflammation with the development of the tubercle is therefore
unnecessary.
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