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THE
THE GIFT OF

ROSWELL P FLOWER

FOR THE USE OF
THE N. Y. STATE VETERINARY COLLEGE



CORNELL UNIVERSITY LIBRARY




924 104 225 499




The original of tiiis book is in
tine Cornell University Library.

There are no known copyright restrictions in
the United States on the use of the text.



http://www.archive.org/details/cu31924104225499



A SYSTEM OF MEDICINE



A



SYSTEM OF MEDICINE



BY MANY WRITERS




EDITED BY



THOMAS CLIFEORD ALLBUTT

M.A., M.D., LL.D., F.E.O.P., F.R.8., F.L.S., F.S.A.

REGIXJS PROFESSOR OF PHYSIC IN THE UNIVERSITY OF CAMBRIDGE,
FELLOW OF GONVILLE AND CAIUS COLLEGE



VOLUME III



¥eSd gorfe
THE MACMILLAN COMPANY

LONDON: MACMILLAN & CO., Ltd.
1897

All riglds reserved



PEEFACE

The delay in the issue of the Second Volume of the System
of Medicine is due to the late appearance of the Eeport of the
Commission on Vaccination. It seemed to the editor and publishers
of this volume, and likewise to the authors of the three sections
on Vaccination, that to publish these sections without the advantage
of the labours of the Cdtnmissioners would be a worse evil than the
delay of some months in issue.

As soon as the Eeport of the Commission was published the
authors of the corresponding sections in this volume completed their
several articles in as short a time as the difficulties of their task
would permit. I owe them my sincere thanks for their loyal
industry.

The issue meanwhile of the volume on Gynaecology testified, I
trust, to the desire of the editor and of the publishers to fulfil
their engagements with the public as punctually as circumstances
permitted.

In respect of the future, I am glad to be able to say that the
articles to appear in the third and fourth volumes are all in hand,
and most of them are printed.



VI SYSTEM OF MEDICINE



I have again to express mj thanks to Dr. EoUeston for his
valuable help in proof-reading and in many other ways ; to Dr.
Manson for reading the proofs of Professor Osier's article on
Malaria ; to Dr. Andrew Davidson for the same kind service for Dr.
Lafleu*, and to Mr. Shipley of Christ's College for final revision of
some details of zoology.

The attention of the reader is directed to the appendixes on the
Serum Diagnosis of Typhoid Fever, by Dr. Del^pine ; on the Serum
cure of Plague, by Dr, Payne ; and on the Bacteriology of Yellow
Fever, by Dr. Davidson.

T. C. A.
Casibbidoe, 1897.



CONTENTS



INFECTIVE DISEASES OF CHRONIC COURSE



Tuberculosis. Dr. Sidney Martin
Leprosy. Dr. PMneas Abraham
Actinomycosis and Maduea Foot.



Dr. Acland



PAGE

3

41
81



• DISEASES OF UNCERTAIN BACTERIOLOGY



(a) Not Endemic

Measles. Dr. Dawson Williams .

Rubella. Dr. Dawspn Williams .

Scarlet Fevj:e. Di. Oaiger

Chicken-Pox. Dr. John MacOombie

Small- Pox. Dr. John MacCombie

Mumps. Dr. Eustace Smith

Whooping-Couqh. Dr. Eustace Smith .

Constitutional Syphilis. Mr. Jonathan Hutchinson

Coexistence .of Infjictious Diseases. Dr. Caiger



117
122
178
183
233
238
251
286



(J) Topical or Endemic

On the Climate and some of the Fevers of India. Sir Joseph Fayrer . 295

Typhus Fever. Dr. John William Moore ..... 353

Dengue. Dr. Patrick Manson . . . . . . . 376

Yellow Fever. Dr. Andrew Davidson ...... 385

Dysentery. Dr. Andrew Davidson . . . . 408

Beriberi. Dr. Patrick Manson ....... 439

Malta Fever. Dr. Lane Notter ..... 463

Epidemic Dropsy. Dr. Kenneth MacLeod ..... 475

Negro Lethargy, or Sleeping Sickness. Dr. Patrick Manson . . 479

Oriental Sore. Surgeon-Major Firth . . ^ . . . . . 486

Verruga. Surgeon-Major Firth ... ... 496

Frambcesia. Surgeon-Major Firth . ... 501



VlU SYSTEM OF MEDICINE



INFECTIVE DISEASES COMMUNICABLE FROM ANIMALS

TO MAN

(a) Of Certain Bactekiology

FADE

Glanders (Faect). Dr. Sims Woodhead ..... 513

Anthrax. Dr. John Henry Bell ...... 525

(J) Of Uncertain Bacteriology

Vaccinia. Dr. Theodore Dyke Aeland, Dr. Monckton Copeman, Mr. Ernest

Hart ......... 555

Foot and Mouth Disease. Prof. McFadyean ..... 685

Rabies. Dr. Sims Woodhead ....... 692

Glandular Fever. Dr. Dawson Williams . . . . .716

DISEASES DUE TO PROTOZOA

Malarial Fever. Dr. William Osier ...... 721

HiEMOGLOBlNURio Fever. Dr. Monckton Copeman .... 742

Am<ebio Dysentery. Dr. Henri A. Lafleur ..... 753



INTOXICATIONS



787
792
807



809
839
874



Poisoning by Food (Ptomaine Poisoning). Dr. Sidney Martin
Grain Poisoning. Dr. Clifford Allbutt .....
Mushroom Poisoning. Dr. Clifford Allbutt ....
Snake-Poison and Snake-Bite. Mr. Charles James Martin and Dr,

Calmette ........

Alcoholism. Dr. KoUeston ......

Opium Poisoning, and other Intoxications. Dr. Clifford Allbutt .
Metallic and some other Forms of Poisoning : including Poisonous

Trades. Dr. Thomas Oliver ...... 920

INTERNAL PARASITES

Psorospermosis. Dr. Joseph Griffiths ...... 1003

Worms — Platyhelminthes and Nemathelminthes. Dr. Patrick Manson . 1006

BiLHARZiA H^matobia. Dr. Guillemard ..... 1091

Hydatid Disease. Dr. Verco and Prof. Edward Charles Stirling . . 1102

ADDENDA

Sbro-Diagnosis of Typhoid Fever ...... H45

Supplement to the Article "Plague" ..... 1150

Addendum to "Yellow Fever" \ . . . . . . 1152

INDEXES 1153



ILLUSTKATIONS



riG.




PAQE


1.


Section of Liver affected with Actinomycosis


84


2,


3. Malformation of Teeth in Constitutional Syphilis


281


i.


Vaccinia : Supernumerary Vesicles. Stage i. . . .


566


5.


3, )) ), 3) ^^' ■ • .


567


6.


33 iii-


567


7.


„ Inoculated Small-pox .....


568


8.


,, confluent at point of Inoculation


570


9.


,, generalised by Auto-inoculation ....


574


10.


33 33 33 33 ■ . • .


575


11.


Vaccinal Ulceration .......


615


12.


Syphilis


615


13.


Lupus affecting the Seat of Vaccination ....


623


14,


15, 16. Psorosperms in varying degrees of Maturity


1004


17.


T. mediocanellata .......


1010


18.


Head of T. tnediocanellata ......


1010


19.


Cysticerous of T. mediocanellata in Beef ....


1011


20.


Cysticercus T. mediocanellata .....


1011


21.


Head of T. solium .......


1012


22.


Ripe and half -ripe Proglottides of T. solium


1012


23.


Cysticerous of T. solium in Pork .....


1013


24.


Cysticercus T. solium ... ...


1013


25.


Taenia nana ........


1015


26.


Bothriocephalus latus . . . . . ' .


1017


27.


Head of Bothriocephalus latus .....


1018


28.


Larvae of ,, 33 •


1018


29.


Distomum hepaticum .......


1023


30.


„ „ showing ovarian, uterine, and testicular Structures


1024


31.


„ conjunctum ......


1025


32.


,, sinense .......


1026


33.


,, crassum .......


1027


34.


„ heterophyes ......


1027


35.


„ Ringeri .......


1028


36.


„ ,, magnified .....


1028


37.


,, ophthalmolium ......


1029



SYSTEM OF MEDICINE



FIG.

38. Aiinphistomum Aominis

39. Ascaris lumbricoides .

40. „ mystase

41. Oxyuris vermicularis — Male and Female

42. AnTcylostomum, duodenale

43. „ „ —Male

44. Trichocephalus hominis — Male and Female .
45., Trichina ; capsule, with connective tissue covering

46. Mature Trichina spiralis — Male and Female

47. Filaria loa — natural size

48. „ magnified

49. Filaria medinensis

50. „ ,, transverse Section

51. „ „ side and front Views

52. „ „ showing lateral Caudal Sacs

53. Filaria Persians

54. Filaria nocturna

55. „ „ showing Sheath

56. „ ,, casting its Sheath

57. Filaria Bdncrofti — natural size

58. ' „ ,, magnified

59. F. Demarquaii and F. nocturna

60. Embryo Hhabdonema intestinale

61. Angidllula sUrcoralis — Male .

62. „ ' ,, Female

63. Filariform' Embryo of Anguilliila stercoralis

64. Male B. koematobia, with Female partly enclosed in Gynsecophorio Canal

65. Fibrinous Clot from Urine showing Ova of Bilharzia

66. Bilharzia Ovum and contained Embryo

67. Free Embryo of Bilharzia ...

68. Capillaries of the Vesical Mucous Surface, showing Ova within

69. Surface of Mucous Membrane of Bladder from a Case of Bilharzia Disease

70. Section from Eectal Mucous Membrane from a Case of Bilharzia Disease

71. Tcenia echinoooccus . . ■ ■ . . .

72. Hooks of Echinococcus ....

73. Reproductive Organs of T. echinococcus during fertilisation .

74. Early Stages of Development of Brood Capsule and ScoUces .

75. Later Stage of Development of Brood Capsule, showing external and internal

Scolices ••......

76. Soolex witli invaginated anterior Extremity ....

77. Scolex partially constricted ......



PAOS

1029

1031

1035

1036

1039

1042

1047

1048

1051

1059

1059

1060

1062

1063

1063

1067

1069

1070

1072

1072

1073

1086

1088

1089

1089

1090

1091

1094

1095

1096

1098

1099

1099

1104

1105

1105

1108

1109
1109
1109



ILL USTRA TIONS



CHARTS

PAGE

Deaths from Measles (50 years, 1841-90) ...... 99

Scarlet Fever deaths, England and "Wales (30 years, 1861-90) . . .126

Scarlet Fever admissions into Metropolitan Asylums Board and London Fever

Hospitals (16 years, 1875-90) ...... 126

Post-scarlatinal Diphtheria at different stages of Convalescence from Scarlet

Fever ......... 162

Temperature Curves in Yellow Fever ...... 399

Course of Temperature, etc., during two Attacks of Haemoglobinuric Fever in

the same Person ........ 744



MAP

Map showing the Number of Outbreaks of Anthrax in each County in Great

Britain in 1892 ...... To face page 5S1

PLATE

The Parasites of the simple Intermittent and irregular Malarial Fevers. (From

the Johns Hopkins Hospital Reports) . . . To face page 726



LIST OF AUTHOES

Abraham, Phineas S., M.D., B.Sc, F.R.C.S.I., Assistant Surgeon to the Hospital for
Skin Diseases, Blackfriars ; Surgeon for Diseases of the Skin at the Westminster
Hospital ; Editor of Journal of Leprosy Investigation Committte,

Aoland, Theodore Dyke, M.D., F.R.C.P., Physician to St. Thomas's Hospital and to
the Brompton Hospital for Diseases of the Chest ; one of the Medical Officers to
the Eoyal Commission on Vaccination, 1889-96.

AUbutt, Thomas CliflFord, M.D., LL.D., F.R.C.P., F.E.S., Regius Professor of Physio
in the University of Cambridge, Fellow of Gonville and Caius College, Consulting
Physician to the Leeds General Infirmary.

Bell, John Henry, M.D., M.R.C.S., Consulting Medical Officer, Bradford Infirmary;
Surgeon, Bradford Eye and Ear Hospital.

Caiger, Frederick Foord, M.D., B.S., M.R.C.P., D.P.H., Medical Superintendent and
Lecturer on Infectious Diseases, South- Western Fever Hospital, Stockwell.

Oalmette, Albert, M.D., Director of the Pasteur Institute of Lille, Professor of
Bacteriology and Experimental Therapeutics to the Faculty of Medicine of Lille.

Copeman, Sydney Monckton, M.D., M.R.C.P., D.P.H., Medical Inspector to H.M.
Local Government Board, Whitehall ; Lecturer on Hygiene and Public Health
in the Westminster Hospital School of Medicine.

Davidson, Andrew, M.D., F.E. C.P.Ed., late Visiting and Superintending Surgeon,
Civil Hospital, and Professor of Chemistry, Royal College, Mauritius.

Fayrer, Sir Joseph, Bart., Surgeon-General, K.C.S.L, LL.D., M.D., F.R.S., F.E.C.P.,

late President Medical Board, India Office.
Firth, Robert Hammill, Surgeon -Major, F.R.C.S., D.P.H., Assistant Professor of

Hygiene in the Army Medical School at Netley.
Griffiths, Joseph, M.D., CM., F.R.C.S., Surgeon to Addenbrooke's Hospital,

Cambridge.
Guillemard, Francis Henry Hill, M.D., F.L.S., etc., late Lecturer on Geography

to the University of Cambridge.

Hart, Ernest, D.C.L., M.R.C.S., 'KAitoT of the British Medical Journal.

Hutchinson, Jonathan, M.D., LL.D., F.R.C.S., F.R.S., Consulting Surgeon to the
London Hospital; Senior Surgeon to the Hospital of Diseases of the Skin, Black-
friars ; Consulting Surgeon, Eoyal London Ophthalmic Hospital.



SYSTEM OF MEDICINE



Lafleur, Henri A., M.D., Assistant Professor of Medicine and Associate Professor
of Clinical Medicine, M'GiUl University ; Physician to Out-patients, Montreal
General Hospital.

MacOombie, John, M.D., CM., Superintendent of the Brook Hospital, Shooters Hill,
formerly of the South-Eastern Small-pox Hospital.

MacLeod, Kenneth, Brigade Surgeon Lieutenant-Colonel, M.D., LL.D., F.K.C.S.E.,
late Professor of Surgery in the Medical College of Calcutta.

MeFadyean, John, M.B., CM., B.Sc, F.E.S.E., Principal and Professor of Compara-
tive Pathology and Bacteriology in the Eoyal Veterinary College.

Manson, Patrick, M.D., LL.D., F.R.C.P., Physician to the Seamen's Hospital, Albert
Dock Branch ; Lecturer on Tropical Diseases to St. George's and Charing Cross
Hospitals.

Martin, Charles James, B.Sc, M.B., M.E.C.S., Professor of Physiology in the
University of Melbourne.

Martin, Sidney, M.D., F.E.C.P., F.E.S., Fellow and Professor of Pathology of Uni-
versity College ; Assistant Physician, University College Hospital ; Assistant
Physician, Brompton Hospital for Diseases of the Chest.

Moore, J. "W., M.D., M.Ch., F.E.CP.I., Physician Meath Hospital and County Dublin
Infirmary; Professor of Practice of Medicine, E.G. S.I,; Consulting Physician, Fever
Hospital, Cork Street, Dublin ; Diplomate in State Medicine, Trin. Coll. Dubl.

Notter, Lane, M.D., M.Ch., Professor of Military Hygiene in the Army Medical
School, Netley.

Oliver, Thomas, M.D., F.E.C.P., Physician to the Newcastle-upon-Tyne Infirmary,
and Professor of Physiology in the University of Durham.

Osier, William, M.D., F.R.C.P., Professor of Medicine in the Johns Hopkins
University, and Physician-in-Chief to the Johns Hopkins Hospital, Baltimore.

Eolleston, Humphry Davy, M.D., F.E.C.P., late Fellow of St. John's College, Cam-
bridge ; Assistant Physician and Lecturer on Pathology to St. George's Hospital ;
Assistant Physician to the Victoria Hospital for Children.

Smith, Eustace, M.D., F.E.C.P., Physician to the East London Hospital for Children,
and to the City of London Hospital for Diseases of the Chest.

Stirling, Edward CharleS; O.M.G., M.D., F.E.S., F.E.C.S., C.M.Z.S., Director of the
South Australian Museum, late Senior Surgeon to the Adelaide Hospital, and
Lecturer on Biology in the University of Adelaide.

Verco, Joseph Cooke, M.D., F.E.C.S., Lecturer on Medicine in the University of
Adelaide, late Senior Physician to the Adelaide Hospital, South Australia.

Williams, Dawson, M.D., F.E.C.P., Fellow of University College, London ; Physician
to the East London Hospital for Children.

Woodhead, German Sims, M.D., CM., F. E.G. P. Ed., F.R.S.E., Director of the Eesearch
Laboratories of the Conjoint Board of the Eoyal College of Physicians and
Surgeons.



ERRATA IN VOL. I.

Page 135, Sect, iv., line 7, for " J. of Pathol." read " J. of Physiology."
Page 503, for " (29) Amoebic Dysentery " read " (29) Dysentery," and " (44)
Amoebic Dysentery " to follow " (43) Blactwater Fever."
Page 503, /or "(19) Rubeola" read "(19) Rubella."



In order to avoid frequent interruption of the text, the Editor has only inserted
the numbers indicative of items in the lists of " References " in cases of emphasis,
where two or more references to one author are in the list, where an author is
quoted from a work published under another na/me, or where an authoritative state-
ment is made without mention of the author's name. In ordinary cases an author's
name is a sufficient indication of the corresponding item in the list.



INFECTIYE DISEASES OF CHKONIC COUESE

15. TUBERCULOSIS 16. LEPROSY 17. ACTINOMYCOSIS



TUBEECULOSIS

Definition. — Tuberculosis is a chronic febrile disease, produced by
the bacillus tuberculosis. It occurs as a natural disease in human beings
and some of the domesticated animals, but, so far as is known, does not
occur in wild animals. It is widely prevalent in the human race and in
cattle. One-seventh of mankind die of tuberculosis, and the prevalence
in cattle may be stated as varying from 10 to 20 per cent of all cows.

Bacillus Tuberculosis (Ivoch, 1882). — The bacillus which is the cause
of tuberculosis is a parasitic, and not a saprophytic, micro-organism. In
nature, so far as is known, it giows only in the iDodies of animals affected
by the disease. Outside the body it can be cultivated in specially pre-
pared media, but it does nut occur naturally in any particular soil or
medium.

It consists of slender rods, varying in length between 1'5 and 3 '5 /x.
They are often bent, and when long may present a beaded appearance.
This beaded appearance is due to the presence of clear areas in the rod,
which were at first considered by Koch to be spores. There is, however,
no evidence that the bacillus forms spores ; and it is improbable that it
does so.

Reaction to Stains. — The bacillus behaves in a characteristic manner to
some of the aniline dyes, and is thus distinguishable from all other micro-
organisms except that of leprosy. It takes up the stain of fuchsin and of
gentian violet when these are dissolved in an alkaline liquid, or in one
containing carbolic acid or aniline. The colour is not removed by mineral
acids up to 25 per cent or by alcohol. The most convenient method
of staining tubercle bacilli, whether in the sputum or in tissues, is to use
a solution of fuchsin dissolved in carbolic acid, as follows : — Fuchsin 1
gramme, alcohol 10 c.c, 5 per cent solution of carbolic acid up to 100 c.c.
The preparation is stained for five minutes to a quarter of an hour in this
solution, which is warmed till the steam rises, and is then placed in a 25
per cent solution of sulphuric acid until it is decolorised. As a rule
this takes a minute or two, but no harm comes to the preparation if it
be left a quarter of an hour in the acid. It is then well washed in dis-
tilled water, to get rid of the excess of acid, and as a rule it takes on a



SYSTEM OF MEDICINE



faint pink tinge. It must now be counter-stained, preferably by a dilute
solution (1 to 2 per cent) of methylene blue. Half to one minute is
sufficient for tliis, and after washing in water, the preparation is ready
to be mounted. Specimens of sputum dried on a cover-glass may be
stained for five minutes in the fuchsin solution, and half a minute in the
methylene blue solution, and mounted, after drying, in Canada balsam, or
examined in water. For sections of tissues it is best to stain for fifteen
minutes in the warm fuchsin solution, after sticking the preparation on
the cover-glass or slide. After counter-staining with methylene blue
the section is to be dried with fine filter paper, washed rapidly with
alcohol, clarified with xylol, and mounted in xylol balsam. By this
method the tubercle bacilli are the only micro-organisms stained red, the
other organisms which may be present being decolorised by the acid.
These, as well as the ground tissue and cells, are stained blue by the
methylene blue.

Gentian violet may be used as a stain for the tubercle bacillus, the
specimen being fixed with iodine solution and decolorised with alcohol ;
bismarck brown, eosin, or vesuviii may be used as a counter-stain. This
method gives very good results ; but the other is more generally ser-
viceable.

Cultivation of the Bacillus. — The bacillus tuberculosis grows best at the
temperature of the body. At low and high temperatures its growth is
impeded or completely stopped. The range of temperature at which it
will grow is between 28° and 42° C. It may be artificially cultivated by
using various media. Solidified blood serum is tlie best for obtaining
the bacillus from the tissues, and was the one used by Koch in his
first research. When the surface of the solidified blood serum is
inoculated with pure tuberculous material, and the tubes are kept
at a temperature of 38° C, no growth appears as a rule during the
first week, but iu from 7 to 10 days white specks are seen on the surface
of the serum which, when examined under the microscope, appear as dry
flakes. The growth extends in a circular manner from these foci, and
the older growths, while still remaining dry, become crinkled and folded,
presenting a very characteristic appe.irance. The growth is very slow, and
it may be weeks before it covers a large area of surface.

The bacillus may also be grown on other solid media, such as blood
serum containing gelatine, or peptone-agar containing 4 to 8 per cent of
glycerine. On peptone-agar without glycerine the bacillus does not grow.
Glycerine not only aids the growth in solid media, but, in the percentage
above-mentioned, stimulates the bacillus to grow in liquid media as for '
example, in peptone-bouillon. It can also be grown on potato in sealed
tubes (Pawlowsky). Grown on solid media the bacillus is apt to lose its
virulence. In liquid media containing glycerine the virulence may be
maintained for a somewhat longer time.

The action of direct sunlight is fatal to the bacillus, as was first
shown by Koch. This has been confirmed by subsequent observations.
Oxygen is necessary for the growth of the bacillus.



TUBERCULOSIS 5

Chemical Products. — But little is known of the chemical products
which are produced by the bacillus tuberculosis in its growth. Koch
separated a substance called "tuberculin," which has a specific action.
This substance, which has not been obtained in a pure state, is prepared
by growing the bacilli for six to eight weeks in a slightly alkaline veal broth,
containing 1 per cent of peptone and 4 to 5 per cent of glycerine. After
cultivation the liquid is evaporated to a tenth of its bulk, and filtered
through porcelain ; this filtrate is the liquid which is called tuberculin :
it contains 40 to 50 per cent of glycerine, which keeps it aseptic. By
adding alcohol the active principle is precipitated in an impure state.
This difi"ers from most of the other bacterial products in resisting
a high temperature, even the boiling-point of water. The specific
action of tuberculin is shown in the fact that it produces a great rise
of temperature in men and animals the subject of tuberculosis, while
similar small doses, injected into healtliy individuals produce no rise of
temperature. The fever ensues from 6 to 12 liours after the injection,
and lasts a varying time — in some cases 24 hours, in others 48, or even
longer. It may produce in a tuberculous individual or animal great
bodily depression, leading to collapse. It was introduced as a curative
agent, but its use is now limited to the diagnosis of tuberculosis in cattle.
Its continued injection in a case of tuberculosis leads to dissemination of
the disease ; so that whereas at first the disease may be limited to the
lungs, after a course of tuberculin the patient may die with disseminated
lesions in various organs of the body. The same observation has been
made in cattle. Tuberculin, therefore, is a specific product of the bacillus,
inasmuch as it has a specific action, namely, that of producing fever, and
so acting on the local processes in tuberculous individuals that the disease
becomes disseminated.

Of the chemical products which the bacillus actually produces in
the body practically nothing is known. There may be a substance or
substances producing caseation, and there must be a chemical body
which produces the fever. These, however, have not been isolated.
Prudden and others found that when injected into an animal the dead
bacilli produced local inflammation and hyperplasia, which ended in
fibrosis. There was, however, no spread of the disease. This efifect was
ascribed to the presence of a hypothetic body — protein — which has been
supposed to exist in the bodies not only of the tuberculosis bacillus, but
of other micro-organisms.

Pathological Effect of the Bacillus. — When injected into animals the
bacillus produces lesions, and the disease which is now to be studied as
tuberculosis. First a local lesion is produced, and from this the disease
spreads to the glands and organs of the body (see Pathology of Tuber-
culosis, p. 15). This statement applies to the bacillus tuberculosis
separated from the lesions of the disease in human beings and in all
affected animals except birds.

Avian Tuberculosis. — Tuberculosis is found as a natural disease in
fowls, pheasants, pigeons, turkeys, peacocks, and other birds which are



SYSTEM OF MEDICINE



kept in captivity. The bacillus, which has heen sejiarated from the



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