TWO KINDS OF CONSUMPTION.

Dominion, Volume 1, Issue 65, 10 December 1907, Page 4

TWO KINDS OF CONSUMPTION.

The second iaterim report of the Royal Commission on Tuberculosis contains an account of elaborate experiments carried out by a Dr. Cobbett at the experimental farms at Blythwood and 'Walpole. The results, while seeming finally to dispose of Koch's view that bovine and human tuberculosis are different diseases, i;aise the important question:—ls tuberculosis one disease or two? In the experiments alluded to, cases are mentioned of all known forms of the disease, both as it occurs in children and in adults. The virus was administered to different animals, arid the results' were strikingly constant. The various strains of tubercle bacilli obtained from man were sharply marked off into two classes'. The first group caused rapidly fatal general tuberculosis, while the second, even when given in far larger doses, had only a slight local effect, and the disease tended to undergo a spontaneous cure. This was the case, according to the report, speaking generally, whatever the animal that was employed in the experiment. Thus, the strains that were highly virulent for oxen were- also highly virulent for the rabbit, while those that had a low degree of 'virulence for one, very rarely caused progressive or fatal disease in the other. This essential fact being established, o<: course Koch's theory falls to the ground-, since it shows that two different, strains of. human virus breed true in oxen and cows as they do in man. Further, every endeavour must be continued to stamp out tuberculosis in cows, because this is a wholesale source of infection to man'. But the important point is raised':—How can one be sure'which type of virys the tuberculous patient is suffering from ? What bearing, also, has this discovery of a dual tuberculous state on the question of prevention and cure?, If one virus tends to a rapidly fatal issue, while the other tends to cure itself, it is most urgent that the nature of the tuberculosis which has seized upon a victim should be determined before-, say, he or she alters a career, goes, abroad in search of 'a cure, or seeks the sanatorium. Apparently this can only be done, at present, by carrying out elaborate inoculation experiments. Yet, until cases of tuberculosis are thus discriminated, all conclusions as to the success' attending different modes of treatment maybe vitiated by a fundamental fallacy. The result's of Dr. Cobbett's experiments serve to show that he is dealing with tuberculous bacilli of entirely different virulence, and this would seem to account for the unexpected' successes and the unexpected failures experienced by every medical man in his treatment of this disease. It would be interesting to know what, if any, explanation of Dr. Cobbett's discovery the Faculty put forward, and, if they accept his deductions, how it is proposed to fall, into line with them.