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
According to my researches into this subject this problem will not be
successfully solved by the efforts now being made to secure the use of
sterilized milk. I am, in fact, in doubt whether milk sterilization as
at present practised can much longer pass as a hygienic measure. For
the present, to be sure, we have nothing better. But the discussion
of this question does not fall within the scope of this lecture. I
have quoted the statistics of the high infant mortality in our large
cities merely in order to advance a further epidemiological argument
for my assertion that the infant alimentary tract is defenseless
against infectious agents whether these are living or not. Even the
infectious toxins pass unchanged through the intestinal mucous membrane
of very young individuals, though not through that of healthy older
ones. A real advance in milk hygiene can, however, be begun even
now if the milk be pasteurized at the dairies and not at the large
receiving-stations in the cities. In the raising of calves, this
procedure has proven of great value.
I have made exhaustive studies to discover why the intestinal mucous
membrane of the young should offer so little resistance to the passage
of corpuscular infectious substances. I shall content myself here
with the statement that the mucous membrane of new-born individuals
possesses no continuous epithelial covering and that the gland-tubes of
the ferment-producing glands are little, if at all, developed at this
time.
By having thus presented to you the results of my experiments and
explained my epidemiological views, I have not really deviated from
the subject of the suppression of tuberculosis. We have seen that the
tubercle bacilli which gain access to the system through the alimentary
tract in infancy constitute the important etiological factor in the
production of the tubercular infection which leads to consumption, and
I believe that the realization of this great fact will supply us with
a rational plan for combating tuberculosis. It will be necessary to
strive more than ever to secure a suitable milk diet for new-born and
very young children, one based on sound experimental investigations.
The as yet unsolved problem, that of a rational milk hygiene in the
suppression of tuberculosis, coincides with the problem of milk-feeding
of infants in general. The mode of infection is everywhere the same,
but the infectious agents are of great variety. Most of them excite
acute diseases which end either fatally or in entire recovery; in the
latter case with a simultaneous development of immunity. The virus of
tuberculosis, however, behaves quite differently, creeping in most
insidiously, all unnoticed, and being in this respect analogous only to
the virus of leprosy, of syphilis, or possibly of malaria in tropical
countries. It may be months, years, or decades before the infection
leads to manifest disease. This depends on the virulence of the virus,
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