ction. I then
stated my suspicion that perhaps the tuberculin injection had some
connection with this, just as is often supposed to be the case in human
practice. With my present very large amount of material for observation
at hand I may express the following opinion: Such an acute development of
tuberculosis as a result of tuberculin injection is to be feared only
exceptionally, and then in cases of advanced tuberculosis. _It must not
be forgotten that acute miliary tuberculosis by no means rarely
accompanies an advanced tuberculosis of long standing._ It is therefore
impossible to offer strict proof of the causal connection with the
injection, and only oft-repeated observation could make this probable.
In support of my view I offer the following: In the course of the last
three years I have made careful post-mortem examinations of 83
tuberculous animals, which have been removed from my experiment farm,
Thurebylille. Among these were 18 (or, strictly speaking, 23) high-grade
tuberculous animals. I have been able to prove miliary tuberculosis in
only 4 of these. Among the others, which showed less developed
tuberculosis, I have never found miliary tuberculosis, and with very many
I have never found any sign of a more rapid development of the process.
On the contrary, it has been proved that the disease was restricted
locally, often for years, in spite of yearly repeated injections.
Dissections were made at very different periods after the injections--in
17 cases from 4 to 12 days after the last test. In all of these cases
earlier tests had been made months or years before. In 28 cases the
injection took place from 19 days to 2 months before the butchering; in 3
of these cases earlier injections had been made. In 38 cases from two and
one-half months to one year intervened between the last injection and the
dissection. Dissection gives the best explanation of this question, but a
clinical observation, continued for years, of a herd tested with
tuberculin can render very essential aid. If Hess's opinion is correct,
it is to be assumed that tuberculosis must take an unusually vicious
course in such herds, but this I have been unable to prove. At
Thurebylille there has existed for three years a reacting division,
consisting originally of 131 head and now 69. Although these animals are
yearly tested, and although most of them react every year, the division