cept by stamping it out as a whole. And that is exactly what the State Board of Health is trying to do in the present campaign. I am glad that this campaign is helping to spread throughout the state a consciousness of the necessity of all helping in this work."

The Incidence of Bovine and Human Tubercle Bacilli in Man

The controversy regarding the significance of the bacillus of bovine tuberculosis in relation to human hygiene, carried on ever since Theobald Smith, in 1898, made his systematic comparative study of bacilli isolated from man and cattle and pointed out differences between the two types, has lost much of its acrimony says, the Journal of the American Medical Association, in a recent editorial. From a practical standpoint it is, of course, very important to learn whether the bovine and human diseases caused by the respective bacilli are mutually interchangeable. At present it seems to be agreed that while cattle are to a considerable extent immune against the bacillus of the human type, human beings do not enjoy the same safeguard in respect to the bovine bacillus. During adult life, however, the danger of such infection is far less than it is during infancy and early youth.*

In the extensive investigations of Park and Krumwiede, which have furnished some of the most important data respecting the types of tubercle bacilli which sojourn in the human body, it was found that out of a total of 1,042 cases, only 101 were bovine in origin, and over half of these occurred in children under 5 years of age. Incidentally, it may be noted that 51 out of the 59 cases occurring in the 161 infants examined were directly or indirectly traced to alimentary infection, thus emphasizing the importance of a rigid sanitary control of milk supplies, on which infants are so largely depend

ent.

More recently Eastwood and Griffith, in Great Britain, have made a report of the relative distribution of the various strains of tubercle bacilli in human bone and joint tuberculosis, and likewise, in a smaller number of cases, in tubereulosis of the genito-urinary tract in man. For the former investigation the material examined was removed directly from an affected joint or bone, or from an abscess in the neighborhood of such lesion. Out of a total of 261 patients, 55, or 21 per cent., were "bovine" cases. were regarded as a typical. Only 3 of those reported on as harboring the bovine bacilli were over 16 years of age. The incidence of the types is further shown by the fact that whereas under 10 years of age 45 out of 155 cases, or 29 per cent., were bovine, over 10 years only 10 out of 106, or 9 per cent., were of this type.

Ten

In their report of 1910, Park and Krumwiedef described only 2 bovine cases out of a total of

* Compare Hiss, P. H., Jr., and Zinsser, H.: A Textbook of Bacteriology, New York, 1914.

† Park and Krumwiede: Jour. Med. Research, October,

1910.

t Eastwood, A., and Griffith. F.: "The Characteristics of Tubercle Bacilli in Human Bone and Joint Tuberculosis.' Jour. Hyg., 1916, xv. 257; "The Types of Tubercle Bacilli Occurring in Tuberculosis of the Human Genito-Urinary Tract," ibid., 1916, xv. 310.

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65 cases of tuberculosis of bones and joints. Twelve patients with tuberculosis of the genitourinary tract disclosed only one infection of the bovine variety, the persons examined being adults, with one exception. Seventeen cases, which were about equally distributed between the genital organs and the urinary tract, were investigated by the British bacteriologists. The bacilli obtained were of the "human" type in fourteen cases, and "bovine" in three, the latter involving affections of the kidneys in persons aged, respectively, 25, 19 and 20 years. Investigations of this sort, laborious as they are, seem well worth while from the standpoint of public health propaganda. They give added assurance that although human adults are perhaps reasonably insusceptible to bovine infection, this mode of transmission can take place even beyond the years of infancy and childhood, in which the danger is unquestionably great.

Star Ranch

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Treatment: Outdoor life, in

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References: County and

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State Medical

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