The bacillus tuberculosis and the etiology of tuberculosis : is consumption contagious? : second communication, read, by invitation, before the Philadelphia County Medical Society, November 14, 1883 / by H.F. Formad.

  • Formad, H. F. (Henry F.), 1847-1892.
Date:
1884
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Credit: The bacillus tuberculosis and the etiology of tuberculosis : is consumption contagious? : second communication, read, by invitation, before the Philadelphia County Medical Society, November 14, 1883 / by H.F. Formad. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Martin’s assertion also, that inocula- tions with products obtained by the in- troduction of innocuous substances never produce true tuberculosis, and that after a series of re-inoculations these products lose their power of acting even as local irri- tants, is, according to control experiments, positively wrong. On the other hand, views have been expressed, based upon ex- periments (I think also by Martin), that products obtained by inoculation with non-tuberculous substances when re-inocu- lated may gradually become specific, and increase in virulence in producing tuber- culosis. 6. Finally, a given parasite and no other substance should, the conditions remaining the same, be capable of producing a parasitic disease. In my previous studies, judging from the literature alone, I was fully impressed with the idea that tuberculosis had a specific exciting cause, and that it could be induced by inoculation with tuberculous materials. Moreover, having made numer- ous inoculations with tuberculous matters, I convinced myself of this fact. Hence I accepted the view that tuberculosis is inoculable in certain animals. But, at the same time, after repeating, under various modifications, the well- known control experiments, I found that, beyond doubt, even true tuberculosis could be induced by substances other than tuber- cular, and that failures to induce tubercu- losis with tuberculous materials were in certain animals nearly as common as suc- cessful inoculations with innocuous sub- stances. To these experiments I will return in my forthcoming report. It will be also necessary to first con- sider the evidence of those observers who, from the results of their own exhaustive experiments, negatived the exclusive or specific infectious properties of tubercu- lous materials. This negative evidence is by far more voluminous and strong than the admirers of the hypothesis of the con- tagiousness of tuberculosis suppose; ex- cited admirers having especially arisen since the ingenious article of Koch ap- peared. It is, however, remarkable that some of the writers on tuberculosis fail to under- stand that the pivot of the question of the etiology of tuberculosis does not rest upon the fact alone whether or not the bacillus O J induces lesions analogous to tuberculosis, but pre-eminently upon the fact whether innocuous substances have or have not the same effects. Thus, above all, the negative evidence must be carefully inquired into, not by relying upon the crippled and sometimes misrepresenting and meagre quotations of some of the compiling writers, but by submitting the original communications of the authors and experimenters to a careful perusal. Together with the accounts of the much-quoted experiments of investigators who succeeded in inducing tuberculosis in animals with tuberculous substances only, the reading and thorough examina- tion of the records and results of experi- ments of the observers to be mentioned below are unavoidably necessary. The following observers all refer to many or few experiments of their own in which tuberculosis resulted from the inoculation with either innocuous substances or with specific matters other than tuberculous: Lebert, Allgem. Med. Central-Zeitung, 1866. Lebert and Wyss, Virchow's Archiv, vol. xl., 1867. Empis, Report 0/the Paris Internat. Med. Congress, 1867. Burdon Sanderson, British Med. Journal, 1868. Wilson Fox, British Med. Journal, 1868. Langhans, Habilitationschri/t, Marburg, 1867. Clark, The Medical Times, 1867. Waldenburg, Die Tuberculose, etc., Berlin, 1869. Papillon, Nicol, and Laveran, Gaz. des Hip., 1871. Bernhardt, Deutsch. Arch./. Klin. Med., 1869. Gerlach, Virchow's Archiv, vol. li., 1870. Foulis, Glasgow Med. Journal, 1875. Peris, Allgemeine Pathologie, 1877. Grohe, Berliner Klin. IVochenschr., No. 1, 1870. Cohnheim and Frankel, Virchow's A rchiv, vol. xiv., 1869. Knauff, 4itc Versamntl. Deutsch. Natur/orscher, Frank- fort. Ins, Arch./. Experim. Pathologie, vol. v., 1876. Wolff, Virchow's Archiv, vol. lxvii., 1867. Ruppert, Virchow's A rchiv, vol. Ixxii., 1878. Schottelius, Virchow's Archiv, vol. lxxiii., 1878; ibid. xci., 1883. Virchow, Virchow’s Archiv. vol. Ixxxii., 1880. Strieker, Vorlesungen iiber Exp. Pathologie, Wien, 1879. Martin, Med. Centralblatt, 1880, No. 42. Wood and Formad, National Board of Health Bulletin, Supplement No. 7, 1880. Robinson, Philadelphia Med. Times, 1881. Weichselbaum, Med. Centralblatt, No. 19, 1882, and Med. Jahrbilcher, 1883. Balough, Wiener Mediz. Blatter, No. 49, 1882. Wargunin, Allg. Med. Centralblatt, April 8, 1882. Hansell,* Arch./. Ophthalmologic, vol. xxv. * Hansell, who inoculated animals with gummous growths and syphilitic pus, obtained an exquisite miliary tuberculosis from the effect of these substances. In this connection may also be mentioned the following: J Damsch (Centralbl. f. Med. Wissen., July 21.1883), who ob- tained tubercular eruptions and-nodes in the brain in rabbits through inoculation into the eye with the cultivated bacilli ot leprosy. Similar inoculation with leprous material led to a perfect miliary tuberculosis in rabbits in the hands of Kaposi of Vienna (Wiener Med. Presse, January 21 1883) ’ Pfeiffer, Dontrelpont, Cornil and Bates (loc. cit.) had the same experience with lupous material Bodamer (Inaugural Thesis, Univ. of Penn., 1884) had as the result of inoculating with the pure cultivated actinomvces fungus, a striking general miliary tuberculosis in rabbits Inoculation with materials from glanders gives also rise to tubercles in thelungs, etc., notdistinguishableunderthe micro- scope from true miliary uberculosis. But Ldffler, who kindly