of the subject; whose study is now attracting an amount of attention commensurate with its importance, and has established a number of facts of the greatest value in connection with the physical wellbeing of mankind.

The conclusions arrived at in my earlier papers may be summarized as tending to show that many diseases, common to man and the lower animals, are communicable from one to the other, not merely by actual transference, as in the parasitic class, but also by alimentation, and that the flesh of affected cattle is not only deprived of most of its nutritive qualities, but is capable of communicating its specific malady to man, when taken as food. Putting aside many forms of disease, of which this holds true, from their comparative rarity (though that these are by no means unworthy of notice is shown by the fact that from one alone, anthrax, no less than 528 human beings perished in Russia from 1867 to 1870), the chief interest of the inquiry centres in the communicability of the tuberculous class of diseases, and especially of consumption; because not only is this the most fatal to which mankind is liable, but also because, though it has been up to a very recent period a matter of doubt whether the malady, as existing in cattle, is identical with that of man, this question has now been solved in the affirmative, and the evidence in favor of its communicability from one to the other is overwhelming To prove, if proof be needed, that the importance of this class of diseases is not overrated, I may adduce the facts that it is accountable for one-fifth of the entire mortality of this country; and that out of 50,825 deaths which occurred in Paris during the year 1888, 11,592-nearly one-fourth-were ascribed to tuberculous maladies.

The prevalence of tubercle in cattle is remarkable, and its danger is intensified by the fact that it is frequently incapable of being recognized during lifetime, and is revealed only by a post-mortem examination of the organs implicated. Such flesh is freely exposed for sale in this and almost every other country. "Tuberculous cattle are known in the trade as mincers' and wasters,' and in the most marked stage of the disease are sold in quarters of towns where inspection is escaped;" *

* Lancet, July 2, 1888.

and Dr. Carpenter states that an inspector in the Metropolitan Meat Market declared upon oath that 80 per cent. of the meat sent to the London market had tubercular disease. The Glasgow Herald, which has lately devoted special attention to the subject, arrives at results equally startling, based on official reports, the markets in that city being flooded with tuberculous cattle for consumption as food.

And it is to be hoped (says the British Medical Journal *) that the mass of evidence collected as to the nature of the poison of tuberculosis, and the terrible danger to the com

munity from its dissemination, will lead to a complete revolution in the mode of conducting business in the Glasgow dead meat market, and prevent the poorer classes being fed any longer on meat described by a butcher as possibly a shade above carrion, but very little."

66

To such a degree, indeed, does this practice prevail there, that the Sanitary Department of the city has taken steps to test in the law-courts the question of its power to order the destruction of all carcasses of animals found to be affected by pulmonary tuberculosis, whether other organs besides the lungs are affected or not. The case was raised by the seizure by the Sanitary Inspector, acting under the 26th section of the Public Health Act, on the 8th of May, of the carcasses of a bullock and a cow affected by tuberculosis. Hitherto the practice of the meat inspectors has been to cut out any diseased portions, and to pass as fit for food all parts which appeared healthy, and the question which now arose for decision was whether the flesh of an animal could be consumed without risk when tuberculosis was limited to one or more organs-the lungs, for example-the affected parts being removed. The local authority, asserting the risk to be sufficient for the condemnation of the entire carcass, was supported by a number of skilled witnesses, in accordance with the report of the Departmental Committee of the Privy Council and of the International Veterinary Congress of Paris of 1888. Dr. Russell, the medical officer of health for Glasgow, stated that 17 to 18 per cent. of the total deaths in that city were due to tuberculosis, and the tuberclebacillus was found in both carcasses; and evidence was adduced that since 1874 all such animals had been condemned as un

fit for food in Greenock and Paisley, however limited the extent of the disease. Sheriff-Principal Berry has, after mature consideration, issued his decision that the animals in question were unfit for human food, and should be destroyed; and the grounds of his judgment-one that may have very important and widespread results are that it has been proved that tuberculosis was transmissible from animals to man by ingestion, and that though the flesh was to all appearance healthy after the removal of the diseased parts, yet the possibility of tubercle having extended further than was apparent was sufficient to justify its condemnation.

There may be no appearance visible to the naked eye of the action of the bacillus in a

particular part of the animal, and yet it may not improbably be there. The presence of the agent of the disease must precede the vis ible results of its action; indeed, the present case affords an illustration of the danger of

inferring, from the absence of symptoms visi

ble to the unaided eye, that the disease is localized.

And, in concluding his judgment, the sheriff said that, while deeply sensible of the responsibility of condemning, as unfit for food, meat which has hitherto been freely allowed throughout the country to pass into consumption, he was nevertheless of opinion that this consideration must be overriden in the interest of the public health-which is of paramount importance. An appeal to the Court of Session has been lodged against the decision by the representatives of the trades whose interests are involved—and this still awaits hearing.

A similar condition of affairs exists on the Continent. Dr. Richter stated recently, at a meeting of the Berlin Medical Society, that the prevalence of tuberculosis in cattle is much greater than most people suspect, and that he had been in formed by veterinary surgeons that, in some localities in Germany, as many as 50 per cent. are affected; that the animals may show no signs of the disease during life, and no means of accurately diagnosing it are at present known; and that, consequently, its presence is often only revealed by examination after death. In Denmark its extreme frequency has been repeatedly demonstrated, yet we import cattle thence into this country for food to the annual value of five millions sterling.

At the Congress on Tuberculosis held in Paris in July 1888, special attention was directed to the subject. Many leading medical authorities dilated on the grave yet unsuspected danger to the public. M. Nocard, quoting the high authority of the late M. Bouley, urged that, if an animal presented signs of tubercle in any organ, howsoever localized, it should at once be rejected as unfit for food; and M. Toussaint declared that a large proportion of the cattle sent to the abattoirs in France suffer from the malady, and that its presence has hitherto not been considered sufficient to disqualify them for sale in the markets. The only town, as far as I know, in which a systematic inspection of all dead meat is enforced is Hanover, and my authority is the late Mr. Jenkins, secretary to the Royal Agricultural Society, who stated, in a letter to the Times, that none is allowed to be sold there unless it is

stamped by the official inspectors; and before the stamp is affixed a careful examination of the various organs is made by experts continuously employed for the purpose. In the month preceding Mr. Jenkins's visit, about 8,000 pounds' weight of meat was condemned as tuberculous, and he adds: "It is well known that this fatal disease can be communicated by meat taken as food ;" and "there is no control in London of the nature of that which I have indicated as existing in the markets of Hanover. I do not know to what extent the 'kosher' meat of the Jews is examined, and the number of cattle consumed in London which are thus affected can only be guessed at some salesmen have expressed their conviction that it is very large. But, if we apply the Hanoverian standard, we shall find that 7,500 head of cattle thus affected are eaten by Londoners every year, and that, at the ordinary rate of computation, at least 375,000 of the inhabitants of the metropolis run the risk of being tainted with consumption, and transmitting it to their unborn children. To this huge danger must be added the scarcely smaller (if, indeed, not greater) one, of this fatal disease being communicated by dead meat imported into London both from country districts and from foreign lands." Mr. Jenkins concludes that

as tuberculosis cannot be detected during the life of the animal, unless almost at its last gasp, the magnitude of the evil seems to call for a complete investigation, with

a view to the establishment of an early and compulsory control."

As regards the results of examination according to the Jewish method, the most recent returns show that, during a period of six months, of 13,116 oxen slaughtered in London, only 6,973 were passed as coming up to the admissible standard; and taking the average of the last five half-years, 40 per cent. of the oxen, 29 per cent. of the calves, and 23 per cent. of the sheep were rejected.

That the New World fares no better than the old in this respect is shown by the report on the prevention of tuberculosis made to the Board of Health of the city of New York, by the Pathologists of the Health Department: * who affirm that "it is a distinctly preventable disease" that it may be, and is, transmitted by the milk and flesh of affected animals; "and that those measures of precaution alone answer the requirements which embrace the governmental inspection of daily cows. and of animals slaughtered for food, and the destruction of all those found to be tuberculous."' And at the recent International Medical Congress held at Melbourne, Dr. MacLaurin, the President of the New South Wales Board of Health, gave some noticeable figures tending to support the conclusion that the use of meat from tuberculous cattle constitutes a very real source of danger, and is the cause of much of the great mortality from phthisis in the colony. The evidence taken before a Commission in Victoria showed the great prevalence of tubercle in stock in Australia, and Dr. MacLaurin, describing the precautions taken in the selection of animals free from blemish by the Jews, adduced the remarkable fact, that among the Jewish population of New South Wales, numbering 4,000, and dwelling mostly in the towns, but one death from consumption had occurred in three years, whereas if the disease had been as prevalent among them as in the rest of the population, thirteen or four teen would have succumbed.

The next link in the chain of evidence is as to the identity of human and bovine tuberculosis, which was for long undetermined, but has now been definitely solved in the affirmative. An elaborate essay by Dr. Creighton on "Bovine Tuberculosis

* New York Medical Record, xxxv. 613.

in Man" has afforded convincing proof, not only of this, but also of its communicability from the one to the other. And Dr. Parkes, assistant to the Professor of Hygiene in University College, London, has shown*"that the bacilli of bovine tuberculosis are identical-according to all bacteriological methods at present known-with those found in tubercular formations in the organs of man. In the statement previously quoted, Dr. Richter affirms that there can no longer be any doubt as to the identity of the two; and M. Chauveau, the President of the Paris Congress on Tuberculosis in 1888, reported that the experiments carried out in the Veterinary School of Lyons to determine the point have fully established their absolute identity. In two lectures devoted to the consideration of the subject, Dr. Woodhead, superintendent of the laboratory of the Edinburgh Royal College of Physicians, gave it as the result of his observations that the bacillus of tubercle in men and the lower animals was identical, and that this point may now be regarded as finally settled.

Evidence as to the communicability of tuberculosis to man from the flesh of affected cattle has been freely forthcoming since my earlier papers: the subject is engaging the attention of pathologists in almost every country, and the results of their investigations yield abundant testimony to the development of the malady-or the predisposition to it-from this source. Dr. Parkes, in the lecture already noticed, states that it may be fairly assumed that in many cases of tubercle in the human subject the virus has been introduced with the food, and its absorption has taken place through some portion of the digestive tract, the incidence of the malady in these organs being especially marked in children. In a weighty address "On the Relations of Minute Organisms to certain specific Diseases," Dr. Klebs, Professor of Pathological Anatomy in the University of Prague, summarizes our knowledge in the assertion that "the conclusion which appears to me to follow inevitably from this survey of the results of modern investigation is this: that specific communicable diseases are produced by specific organisms." Dr. Woodhead, in the lectures delivered by him as Sanitary Scholar of

* British Medical Journal, April 21, 1888.

the Grocers' Company in 1888, said that all cases of rapid infective phthisis are the result of the action of the bacillus, the differences observed being due to the resisting power of the tissues involved, and the number and activity of the attacking bacilli. These, as shown by the researches of Weigert, Ponfick, and Coats, pass into the general circulation of the blood, in which they are frequently found, and thence into the organs of the body where the tuberculous changes occur. Dr. Woodhead expressed his concurrence in the view that the flesh and milk of affected animals convey the bacillus, and that its effects would depend entirely upon the resisting power of the tissues and the general health of the individual in weakly persons, especially in children with their imperfect nutritive power, the tissues are apt to give way on the slightest stimulation, and if their vitality be low, the introduction of even a small number of bacilli suffices to produce scrofulous degeneration of the glands, upon which well-marked tuberculosis may ensue.

Special attention was devoted to the consideration of the subject at the Congress on Tuberculosis held in Paris in 1888, and the President, M. Chauveau, confirmed the results of the experiments made by himself and MM. Villemin and Cornil on its artificial production in healthy animals fed upon tuberculous matter. This had been previously demonstrated by M. Toussaint, who had also proved that the bacillus of tubercle can withstand a high degree of heat without losing its vitality, so that he had produced the malady in cattle by feeding them with the juice expressed from the steak of a tubercular ox, cooked so as to be slightly underdone. To this crucial experiment was added the equally weighty and practical statement, as the outcome of investigations by MM. Strauss and Wurtz, that these bacilli were not destroyed by the action of the gastric juice, when ingested by the human subject. Their method of action appears to be by the production of a fermentative process, and this, once in operation, is not arrested by the death of the bacillus. The chief resolution arrived at by this Congress was—

That every means, including the compensation of owners, should be taken to bring about the general application of the principle that all meat derived from tubercular animals, whatever

the gravity of the specific lesions found in them, should be seized and totally destroyed.

For the past three years, the French Government has been contemplating the extension of a law, passed in 1881 (to prevent the spread of the contagious diseases of animals), to include cases of tuberculosis; and the President of the Republic signed the necessary decree during the session of this Congress. This decree is of great sanitary significance: it provides that every animal of the bovine species found to be suffering from this malady shall be isolated, and that a veterinary inspector shall be present when it is slaughtered, and make a report on the post-mortem appearances: the flesh is to be condemned as unfit for consumption if the lesions are generalized or have affected any part used as food. Two other resolutions were adopted, to the effect that, tubercle being now legally included in France among the diseases recognized as communicable, a special system of inspection of dairies should be established to as

certain that the cows are not in a condi

tion to communicate any contagion to the human subject through milk; and that steps should be taken to spread among the public a knowledge of the danger incurred by the ingestion of the flesh or milk of tubercular animals. In reporting these results, the British Medical Journal (September 29, 1888) is of opinion that

it appears that by far the most important work achieved by the Congress was the adoption of these resolutions. They deal indeed with only one element in the etiology of tubercular disease, but that not the least influential in its action, while practically it is the most important, because its operation is most under control.

Similar measures are now advocated in Germany, and at a meeting of the Berlin Medical Society in March of this year Dr. Richter urged that the sale of meat from tuberculous cattle should be forbidden by legislative enactment. In this country the British Medical Association has represented to the Government the necessity of stringent regulation of our meat supply; and at a recent meeting of the Scottish Veterinary Association, a resolution was carried unanimously in favor of legislation with a view of suppressing the consumption of meat from tuberculous animals, and of securing a proper inspection at the abattoirs. Indeed, the communicability