DR. KOCH ON CONSUMPTION.

Auckland Star, Volume XXXII, Issue 203, 7 September 1901, Page 2 (Supplement)

DR. KOCH ON CONSUMPTION.

THE SOURCES OF INFECTION

<From Our London Correspondent.)

LONDON, July 26,

Of the papers read and discussed at the Tuberculosis Conference in London this week that of Dr. Koch's attracted by far the greater attention among the general public It is well that our people should read, mark, learn and inwardly digest the paper of Dr. Koch, for it is the people themselves rather than medical men who must take that decisive action which will render the world more „or less free from what has been truly termed the dominant scourge of the human race. The vast majority of people even at this period in the world's history believe that consumption is hereditary, and that when once it shows itself it is incurable. They are not aware that a perfectly healthy person may con-, tract the disease by merely living in surroundings where it has .taken hold, and that in its earlier stages it may certainly be cured. Thus, the great enemy that science has to combat is not so much the disease as the ignorance that prevails, whereby the most elementary precautions are neglected and every vantage given to the enemy to strengthen its hold, especially on the poor who live in crowded dwellings, where the most simple sanitary laws axe defied out of sheer ignorance. Perhaps there was nothing in Professor Koch's paper which has not been known to men of science for some time; but unfortunately science is well nigh impotent when it has to defend that tremendous frontier line—the ignorance of the great majority of the population. The main source of the infection of tuberculosis, says Professor Koch, is the sputum of consumptive patients. Hereditary consumption is so rare as to be of^small account; and the same is true as to the extent of infection by the milk and flesh of tubercular cattle. Professor Koch thus narrows the area of infection practically to consumptive patients themselves and the ineffectual means generally taken to prevent infection. The cure or prevention of consumption thus lies, to all intents and purposes, with the people themselves, and the local authorities should pave the way for compulsory measures by diffusion of knowledge as to the nature c. the disease, and the easily availab/e means by which it can be successfully combated.

Perhaps among medical men and those .amoved from the "common j herd" by a knowledge of hygiene the j most interesting part of Dr, Koch's paper was that which dealt with the possibility of tubercular infection from animals. This has been generally regarded as proved, but Professor Koch announced himself as sceptical* His investigations led him to form an opinion different from that generally accepted. Genuine tuberculosis has been observed in almost all domestic animals, most frequently in poultry and cattle, but the tuberculosis in poultry was so different to the human that the professor thought it might be left out of account. He had from the first regarded the identity of bovine and human tuberculosis with reserve, and in order to decide the question he made experiments, first on rabbits and guinea pigs, without satisfactory results, and afterwards on cattle. A number of young cattle, which had stood the tuberculin tests were infected with pure cultures of tubercule bacilli taken from human subjects, but after some months they showed no sign of disease and gained in weight. When they were killed no trace of tuberculosis was found in their internal organs, but at the places where injections had been made small suppurative foci had formed. On the other hand, when the same experiment was made on cattle free from tuberculosis with tubercule bacilli from the lungs of an animal suffering from bovine tuberculosis, symptoms of disease rapidly appeared, fever set in, and some died within less than two months. In short, the cattle proved just as susceptible to infection by the bacillus of bovine tuberculosis as they had proved insusceptible to infection by the bacillus of human tuberculosis. Similar experiments made with pigs, asses, sheep and goats gave like results, and investigations recently made in North America confirmed this view. "Considering all these facts," said Professor Koch, "I feel justified in maintaining that human tuberculosis differs from bovine and cannot be transmitted to cattle. It seems to me very desirable, however, that these experiments should be repeated elsewhere in order that all doubt, as

to the correctness of my assertion may be removed. Owing to the great importance of this matter the German Government has appointed a Commission to make further inquiries on the subject."

[ Lord Lister properly termed Professor Koch's suggestion that bovine ! tuberculosis was incapable oi development in man as being of enormous importance. If correct our means of defence was simplified; but, on the other hand, it would be grievous if our efforts to ensure pure milk and wholesome food were relaxed, and then the theory should turn out to be not altogether correct. Dr. Koch's evidence was not entirely conclusive, and the whole matter should be made the subject of further inquiry. He did not think it necessarily followed that because the human tuberculosis would not develop in the ox that bovine tuberculosis would not develop in the human body.

The nature of the "further enquiry" desired by Lord Lister is easy to guess. The history of medical science contains many instances of men voluntarily risking their lives to prove a theory—the recent work of the School of Preventive Medicine in regard to malarial fever is a case in point-^-and doubtless ere long we shall find men submitting themselves to doses of bovine tuberculosis bacillus in order t<? ascertain whether because the beast is proof against the man's bane man is proof against the beast's bane.

[A French doctor has since the above was written signified his willingness to allow himself to be inoculated with bovine tubercle.—Ed. E.S.]