culture of the bacillus as a means of diagnosing tuberculosis

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54 EDITORIAL ARTICLES. methylated spirit answers quite well. With the exception of brain and spinal cord, any of the organs of the body may be satisfactorily preserved in it. The parts to be examined should always be placed in the spirit while they are still fresh, and, where possible, they ought to be removed from the body immediately after death. The pieces should not be larger than one-inch cubes, and it is better to make them somewhat smaller than that in one of their dimensions. Where the lesion appears to be uniform throughout an organ, or in the case of a tumour, it is not necessary to preserve more than two or three such pieces. I t is advantageous to place them first in a mixture of three parts of methylated spirit to two of water, using three or four ounces of fluid to each piece. At the end of the second or third day the specimens must be taken out, and the liquid must be clianged, substituting an equal quantity of undiluted methylated spirit. After an interval of a week the spirit must be again changed, and in another week the specimens will be ready for cutting. When specimens hardened in spirit have to be cut with the Cathcart or other freezing microtome, they must first be soaked in water. Pieces of about a quarter of an inch in thickness should be placed in a large vessel of water, or in a smaller vessel into which a tap is allowed to drip. They must be left in water for at least twelve hours, and they ought then to be transferred to a mixture of mucilage of acacia, 5 parts, and simple syrup (B.P.), 3 parts. To preserve this mixture,s drops of pure carbolic acid may be added to each ounce. When the pieces of tissue have been thoroughly permeated by the gum and syrup mixture they are ready to be cut. The procedure is exactly the same as that already described in speaking of the cutting of fresh tissue, but it will be found that, owing to the presence of the gum and syrup on the specimen, the latter is less icy-hard when frozen, and better sections are therefore obtainable. CULTURE OF THE BACILLUS AS A MEANS OF DIAGNOSING TUBERCULOSIS. WE learn from a report in the Veterinary Record (March I, 1890) that at a recent meeting of the Yorkshire Veterinary Medical Society tuberculosis came under discussion. As some of the statements then made were of an extraordinary character, and as they fell from the lips of a very prominent member of the veterinary profession, we think it desirable to call attention to them here, and to point out their erroneousness. Professor Williams is reported to have said that" there were three conditions in the cow which were mistaken for tuberculosis. If tuberculosis were due to bacilli, they must be able to detect the bacilli by means which they had now in their hands, before they pronounced

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Page 1: Culture of the bacillus as a means of diagnosing tuberculosis

54 EDITORIAL ARTICLES.

methylated spirit answers quite well. With the exception of brain and spinal cord, any of the organs of the body may be satisfactorily preserved in it. The parts to be examined should always be placed in the spirit while they are still fresh, and, where possible, they ought to be removed from the body immediately after death. The pieces should not be larger than one-inch cubes, and it is better to make them somewhat smaller than that in one of their dimensions. Where the lesion appears to be uniform throughout an organ, or in the case of a tumour, it is not necessary to preserve more than two or three such pieces. I t is advantageous to place them first in a mixture of three parts of methylated spirit to two of water, using three or four ounces of fluid to each piece. At the end of the second or third day the specimens must be taken out, and the liquid must be clianged, substituting an equal quantity of undiluted methylated spirit. After an interval of a week the spirit must be again changed, and in another week the specimens will be ready for cutting.

When specimens hardened in spirit have to be cut with the Cathcart or other freezing microtome, they must first be soaked in water. Pieces of about a quarter of an inch in thickness should be placed in a large vessel of water, or in a smaller vessel into which a tap is allowed to drip. They must be left in water for at least twelve hours, and they ought then to be transferred to a mixture of mucilage of acacia, 5 parts, and simple syrup (B.P.), 3 parts. To preserve this mixture,s drops of pure carbolic acid may be added to each ounce. When the pieces of tissue have been thoroughly permeated by the gum and syrup mixture they are ready to be cut. The procedure is exactly the same as that already described in speaking of the cutting of fresh tissue, but it will be found that, owing to the presence of the gum and syrup on the specimen, the latter is less icy-hard when frozen, and better sections are therefore obtainable.

CULTURE OF THE BACILLUS AS A MEANS OF DIAGNOSING TUBERCULOSIS.

WE learn from a report in the Veterinary Record (March I, 1890) that at a recent meeting of the Yorkshire Veterinary Medical Society tuberculosis came under discussion. As some of the statements then made were of an extraordinary character, and as they fell from the lips of a very prominent member of the veterinary profession, we think it desirable to call attention to them here, and to point out their erroneousness.

Professor Williams is reported to have said that" there were three conditions in the cow which were mistaken for tuberculosis. If tuberculosis were due to bacilli, they must be able to detect the bacilli by means which they had now in their hands, before they pronounced

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EDITORIAL ARTICLES. 55

certain appearances to be true cases of tuberculosis. He maintained that before they could recommend a law to be passed dealing exclu­sively with such cases, they must come to an understanding as to what tuberculosis was. He felt that many animals that were fit for food, though having grapes upon the pleural surface, were condemned by many inspectors without a microscopical examination." Again, in opposition to Mr G. Carter, who had pointed out that many tubercles might be examined without finding any bacilli, Professor Williams said that .. there were other means of detecting tuberculosis. There was cultivation, which in thirty hours would determine the question if the spores of tuberculosis were there. It was no use Mr Carter telling them that the mistake of confounding lymphadenoma with tubercu­losis was not made. It was made every day. The lymphoid -growth that might exist might justify a man in saying it looked like a case of tuberculosis, but an incision into the growth would speedily determine the question. The great distinction between the two was, that in the one rapid degeneration and withering took place, in fact as soon as it was born, whilst in the other there was no tendency to degeneration. Lymphadenoma had a distinct character from tuberculosis, and where the cases were confounded the microscope and cultivation would soon determine which it was."

We gather from these remarks that Professor Williams believes­(I) that cultures of the tubercle bacillus can be obtained in thirty hours; (2) that cultivation of that organism is a practicable method of diagnosing tuberculosis in meat inspection; (3) that there is some exceedingly common non-tubercular disease of cattle which deter­mines the growth of grape-like nodules on the pleural membrane; and (4) that cattle so affected ought not to be condemned as unfit for human food.

We feel it a duty to protest against each and all of these state­ments, and we should be exceedingly sorry to think that they are entertained by any considerable number of veterinary surgeons. Let us consider Professor Williams' opinions on this question seriatim.

On reading that it had been seriously stated that a culture of the tubercle bacillus is obtainable in thirty hours from a tuberculous carcase, our first impression was that the word "hours'" had inad­vertently been used for" days." Clearly, however, that cannot be the explanation, for a meat inspector could not wait thirty days for a culture to grow in order to settle whether the carcase from which he inseminated his tubes was tuberculous or not. A pparently Professor Williams' memory in this matter is at fault. At least no other explanation occurs to us than that he has somewhere read that cultures of the bacillus tuberculosis are obtainable after thirty days' incubation, and that through a lapse of memory he has come .to think that only thirty hours are required.

Coming to the second point-that culture of the bacillus tubercu-

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EDITORIAL ARTICLES.

losis is an operation that is "in the hands" of meat inspectors, and that it is a practicable method of settling whether a carcase is or is not tuberculous in any case of dispute-we cannot characterise the opinion in milder terms than to say that it is altogether absurd, and that it could not be held by anyone who has given serious attention to bacteriological questions. It is possible that Professor 'VVilliams makes no claims to any such knowledge-at least of a practical nature-but if not, he should not jeopardise the credit and status of veterinary knowledge on these subjects by publicly, and ostensibly for the instruction of veterinary practitioners, giving utterance to a state­ment the absurdity of which must be apparent to the merest tyro in bacteriology. Even if every abattoir in the country had attached to it a skilled bacteriologist, having at his command a well-equipped laboratory, culture of the tubercle bacillus would not be of the least value for the purpose of meat inspection. We have no hesitation in saying that if Professor Williams adopts as a test of the fitness of any carcase for human food his inability to obtain a culture of the tubercle bacillus from it, he will never encounter a carcase that is not free from danger. Butchers had better take note of the fact.

The third statement above referred to raises the question-What is this disease, termed lymphadenoma, which is so common that it is daily confounded with tuberculosis? Presumably these are the cases having all the outward characters of tuberculosis, but not ranged under that head because cultures of the tubercle bacillus cannot be obtained from them in thirty hours. At the same time, we fail to see the necessity for attempting to cultivate the organism in such cases, if the mere cutting into the lesions is sufficient to show that the disease is not tuberculosis, but lymphadenoma. That lymphadenoma and tuberculosis are confounded-we would not say every day-we admit, but not in the sense that Professor Williams supposes. It has been shown that what has until recently been called lymphadenoma of the horse is really tuberculosis, the proof consisting not in cultivating the bacilli, but in demonstrating their presence in the lesions by the customary microscopical methods. Probably Professor Williams' every-day cases of bovine lymphadenoma are of the same nature, for his teaching regarding the essential characters of tuberculous new growths is as unsound as his views concerning the cultural peculiari­ties of the tubercle bacillus.

But even granting that cattle were frequently the subjects of some disease simulating perlsucltt, but non - tubercular, we should most strongly dissent from the implied opinion that the carcases of such animals would be fit for the food of man. We have never yet encoun­tered such a case, and our experience agrees with that of many others whose opportunities in the matter are much greater than those of Professor Williams. But should we ever do so, we would unhesi­tatingly, and with as little compunction as in the case of tuberculosis

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REVIEWS. 57

itself, condemn the carcase as unfit for human food. We suppose that this hypothetical lymphadenoma of the ox is a malignant disease, and, although its cause may be unknown, there is no certainty that it is not as communicable to human beings through the medium of diseased meat as tuberculosis.

It is not an agreeable task to have to expose the erroneousness­not to say the absurdity-of views publicly expressed by one holding the position of Professor Williams, but we think it only right to controvert them when, as in this case, they are directly calculated to propagate error in a matter that deeply concerns the public welfare. The veterinary profession has of late been asserting its claims to be the proper guardian of the public health in matters of meat inspection. Of the justice of that claim we are fully convinced, but the enunciation of views such as those we have criticised places a powerful weapon in the hands of those who contend that medical men are as yet in many respects better fitted to act as meat inspectors than veterinary surgeons.

A Practical Guide to Meat Inspection. By Thomas Walley, IvLR.C.V.S., Principal of the Edinburgh Royal (Dick's) Veterinary College, Professor of Veterinary Medicine and Surgery, etc. Edinburgh and London: Young J. Pentland, 1890.

AT the present time there are not wanting indications of a general awakening to the necessity of skilled inspection of the carcases of animals intended for human food. Hitherto a great proportion of the butcher meat consumed in this country has not been submitted to any inspection whatever, and we fear that in the case of a not insignificant part of the remainder the inspection has been of a very perfunctory character. Reform in this direction is urgently required, and doubtless it will come. Indeed, to those who have given serious thought to the matter there may have occurred doubts as to whether, in the event of a law being passed in the near future ordaining a general system of meat inspection, a sufficient number of persons possessing the necessary qualifications could immediately be found. When we use the words "necessary qualification" we do not mean this or that degree-medical or veterinary-but that amount of scientific knowledge and practical acquaintance with the subject which anyone undertaking the duties of meat inspection ought to possess. It is upon members of the veterinary profession that this duty will naturally fall, but it would be folly to assert that the mere possession of a veterinary degree is evidence of competence to act as a meat inspector. Those who intend to offer themselves for such appointments ought, as in the case of similar appointments in France and Germany, to be called upon to give evidence that they have paid special attention to the subject, and Professor Walley has dod'e good service in providing those who are, or who expect to be, engaged in meat inspection with a text-book embodying the result of his wide experience in that kind of work.