The suppression of tuberculosis: $b Together with observations concerning phthisiogenesis in man and animals and suggestions concerning the hygiene of cow stables and the production of milk for infant-feeding, with special reference to tuberculosisBehring, Emil von
Science
The suppression of tuberculosis: $b Together with observations concerning phthisiogenesis in man and animals and suggestions concerning the hygiene of cow stables and the production of milk for infant-feeding, with special reference to tuberculosis
Behring, Emil von
Tuberculosis -- Prevention
The virus of human tuberculosis, the tubercle bacillus of Koch,
possesses narrowly limited morphological characteristics. It is readily
recognized since Koch published his very accurate description of it
in 1882, and especially since Ehrlich, shortly afterward, published
a specific staining procedure. The tubercle bacilli are familiar to
us as rods of varying length, but of fairly constant thickness, which
occasionally show granular degeneration. I believe it is now everywhere
accepted that the presence of these bacilli in a lesion in the human
body indicates the tubercular character of that lesion. Leprous lesions
with somewhat similar bacilli must, of course, be taken into account,
but these, as a rule, can already be differentiated macroscopically.
Recognizing this significance of the presence of Koch’s bacilli
and applying all other known methods for the identification of
tuberculosis, Dr. Naegeli of Zürich, working under the direction of
Prof. Ribbert, was unable to discover at autopsy a single body over
thirty years old in which there were not some signs of the occurrence
of a tubercular infection. Between the ages of 18 and 30 there were
96%; between 14 and 18, 50%; between 5 and 14, 33%; and between 1
and 5 years, 17%, which showed the presence of tubercular lesions.
In the bodies of infants under one year, on the other hand, definite
tubercular signs were invariably absent.
The astonishing results of these careful anatomical investigations have
been verified by reports from pathological anatomists in other cities;
yet at first sight, they seem to contradict all medical and other
experience, for according to these results all of us assembled in this
hall are tuberculous! But the perfected diagnosis of tuberculosis in
the living person leaves no doubt that Naegeli’s figures, at least for
thickly populated centers, possess general applicability. To be sure,
if we count only the patients who come to the physician because of
tubercular or supposedly tubercular symptoms, then our figures do not
agree with Naegeli’s; nor will the statistics of living persons in whom
we can discover tubercle bacilli agree with the autopsy statistics.
The agreement, however, becomes very close if we make use of a
diagnostic method furnished us by the second of Koch’s above-mentioned
discoveries, the tuberculin injection.
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