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
Whether the entrance of tubercle bacilli into the tissue juices of an
individual shall end disastrously or not, depends on a large number
of factors. _Congenital_ differences in the degree of susceptibility
undoubtedly play a subordinate rôle. A more important factor is the
degree of virulence of the inoculated virus, and this may fluctuate
within wide limits. Of great importance also is the amount of the
virus and whether the inoculation is single, repeated, or almost
continuous for a longer time. Of transcendent importance, however, are
the age of the individual, his physiological or pathological condition
at the time of infection, other previous diseases, mode of feeding,
occupation, hygienic conditions of his surroundings, etc. In short, all
that we understand by the term _acquired susceptibility_, or _acquired
predisposition_. Finally, I must mention the location and character of
the point of entrance of the virus.
We see at once, therefore, that, in the analysis of a tubercular
infection, it is not sufficient to have determined the presence of the
three necessary factors, susceptibility, the tubercular virus, and
the opportunity for infection. If we wish to understand the manifold
variety of the reaction phenomena exhibited by an individual infected
with tubercular virus, we must thoroughly study all the conditions
above mentioned as well as a great variety of accidental conditions.
Nowadays the term tuberculosis is applied to everything which
constitutes a change in the organism excited by the entrance into it of
tubercle bacilli. In statistics, galloping consumption is thus classed
with tubercular local infection of a joint, gland, abdominal organ,
of a little nodule in the skin of the face, etc. Calcified as well as
other remains of previous lesions are classed as tubercular. We have
every reason to praise as a great scientific advance the discovery that
in manifestations so varied in their importance to life and health
the etiological factor is the same. One must not, however, make the
mistake of classing as one and the same thing tubercular infection
and consumption and prognosticate an inevitable and painful end on
making the diagnosis of tubercular infection. How little the facts
justify such a course is seen in the statistics of bovine tuberculosis
and will be seen also when I come to speak of the statistics of human
tuberculosis.
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