“The Micrococcus of Tubercle”

Abstract

AN article on “Disease Germs,” by Dr. W. B. Carpenter, in the current number of the Nineteenth Century, contains the following:—“Another line of inquiry which has obviously the most important bearing upon human welfare is the propagability of the micrococcus of tubercle by the milk of cows affected with tuberculosis, a question in regard to which some very striking facts have been brought before the Medical Congress by a promising young pathologist”—naming myself; and I hope that I am sufficiently grateful to a veteran in science for his complimentary if not altogether accurate reference to my work. What I did say at the recent Medical Congress, and at much greater length in a small volume entitled “Bovine Tuberculosis in Man” (London, 1881)—Dr. Carpenter will find it, I think, among his books—was not anything about “the micrococcus of tubercle,” but about a variety of somewhat technical morphological details in respect to which certain cases of tuberculosis in man resembled the tuberculosis or “pearl disease” of the bovine species, I did indeed introduce half a page at the end of my essay to show how clear was the issue between my view of tuberculosis communicated from the cow and the view which Dr. Carpenter has been expounding, and I hope you will have room for the passage:—“The doctrine of a tuberculous virus was stated by Klebs in 1868, and has been advocated by him, as well as by Cohnheim, in recent writings. In its latest form this doctrine asserts the existence of a specific minute organism to whose agency the infection is due. The minute organism is called by Klebs Monas tuberculosum. The method of proof which I have followed in this work makes it impossible that the infective agency of a minute organism should in any way come into my view of the communication of bovine tuberculosis to man. I have rested the whole case upon certain minute identities of form and structure in the infected body, due to the mimicry of infection. Among other points there were the leaf-like and cord-like outgrowths of the pleura and peritoneum, these being the early stages of the lentil-like or pearl-like nodules and their connecting threads; the lymphatic glands, with distinct nodular formations in their substance; the lungs, with smooth-walled closed vomicæ or with encapsuled nodules. In the new formations generally there was a particular pattern of microscopic structure, in which giant-cells and epithelial-like cells figure largely, and there was a relatively high degree of vascularity. In all these points the disease in man is a mimicry of the parent disease in the bovine animal. That mimicry is not only in single features, but it is of the whole disease. It is possible to conceive of the juices and particles of the primarily diseased body acquiring a kind of spermatic virtue which gave them the power to communicate the specific disease as a whole and in all its several manifestations to another body in which they should happen to lodge. But it is hardly possible to think of a neutral living organism being charged with the power of conveying so complex details of form and structure from one body to another” (“Bovine Tuberculosis in Man,” pp. 103, 4).