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At the same time we wish to fix upon . your memory the fact that our sales on ' 'Early Riser" Flour are steadily growing, which shows us that the housewives of McHenry and the sur­ rounding country can easily judge good from poor flour. If you'haven't given it a fair trial, do so at your earliest convenience. Our line of Graham Flour, Breakfast Food, Corn Meal, Rye Flour and Pumpernickel Flour is always fresh and of the very purest that human skill can make it. Try it and convince yourself that these statements are the truth. :: West McHenry Flow and feed Mills WBST McHENRY, ILLINOIS JOHN-SPENCER, Prop- -CENTERV1LLE- Grocery and flarket Always'a fresh and com­ plete line of the choicest of Groceries and Meats. Phoiie, 552. :: CHAS. G. FRETT, McHENRY, -PROPRIETOR- ILLINOIS. J) 1S~ lie Mutual Benefit lite Insuraace Co. NEWARK, NEW JERSEY. I The Leading Annual Dividend Company Hm during the past afxty-four years paid to policyholders, $968,899,648.85 Assets Jan. 1,1909, $121,260,086.89 : Surplus, $6,628,151.17 N* company has accomplished better results (or Its policyholders CARL W. STEINGER, Agent. & DID PROF. KOCH CHANGE HIS VIEWS At to Bovine and Human Tu berculosi* at thelnternatiqrutt Congress held at Washington D, C., in October, 1908? At Springfield last April I qi%ted Professor Robert Koch, as follows: " "It is also to be noted that in 1901, Koch," speaking of tuberculosis, "made his memorable announcement in which he contended that the transmission from the cow to the human was no more freQuent than is hereditary trans missions, and that in fact its occur­ ence is so rare that IT IS NOT AD­ VISABLE TO TAKE ANY STEPS AGA1XST IT." Following this it was claimed that Koch, at the Washington Con­ gress, in October, 1908, reversed his position. I have abstracted substantially ev­ erything Professor - Robert Koch said upon the subject at the Washington International Conference in October, 1908, including his statements at the Joint Session held "in camera," which has been published fully, quoting first his address found on pages 645 to 650, A*oluin« 4, Part 2, Section 7, of the Sjpth International Congress of Tu- •e%ri*ulosi,s Washington, D. C-, Septem­ ber 2Sth to October 5th, 1908, as fol­ lows: "The question whether or not human and bovine tuberculosis identical is indeed of hlifli interest. But the practical ituo^>rLaft<e of the ques­ tion whietT"~ com-trn<flB^^>reventioii of tuberculosis is of 9H^RP|(i: ; import­ ance. For this Hi confine myself solely to a c^BBpf;?:i. n of the practical side of the ijuuj To Theobald Smith, of Harvard, be­ longs the credit of having been the first to call attention to certain differ­ ences between the tubercle bacilli found in man and in cattle. It was his work which induced me to take up this same study. 0 In co-operation with Sehutz, I have undertaken a series of experiments for which we selected cattle, these, animals being especially suited for such work. The results of these experiments have led me to conclusions which I have first communicated to the BritisM^on- gress on Tuberculosis in 1901. They are in substance as follows: 1. The tubercle bacilli of bovine tuber­ culosis are different from those of hu­ man tuberculosis. 2. Human beings may be Infected by bovine tubercle bacilli, but serious dis­ eases from this cause occur very rarely. 3. Preventive measures against tuber­ culosis should therefore be directed pri­ marily against tlie propagation of hu­ man tubercle bacilli. I did not expect that my personal views on the relation of human and bovine tuberculosis would be accepted as finsl. but 1 have asked that the experiments of Schutx and myself be repeated. This has been done since by a host of investigators. Many sources of error must be consid­ ered in research on tuberculosis, and only work in whicli these errors have been definitely excluded can be accept­ ed as conclusive. My personal estimate of the value of the work of other authors depends on how far these errors haw been elimi­ nated. For this reason I will now sum­ marize briefly the .requisites for con­ clusive work on the differentiation be­ tween human and bovine tuberculosis. The animals used for experimentation must be entirely free from spontaneous tuberculoids. x x During the entire period of investiga­ tion the animals, that is, cattle, rab­ bits. and guinea-pigs, must be protected figidly against tuberculous infection, x Inoculation of animals should be made *ubcutaneous|y with weighed quantities •f a culture of the tubercle bacillus, x x In the preparation of the cultures It is necessary that even while obtain­ ing crude material all precautions must be followed which serve to prevent a contaminating infection either during the inoculation or In the making of the cultures, x x For standardization of virulence rab­ bits may be used, as a rule, in place of cattle. In all doubtful cases, however, the test must be made on a correspond­ ing number of cattle, x x It is well to appreciate that mixed Infection by human and bovine tubercu­ losis may occur. In such cases, if prop­ er precaution is not taken in animal ex- pertinents, bovine tuberculosis will -•«y5 gain supremacy aiiu lead to ©rn>i'. With regard to experiments in feed­ ing phthisical sputum, the following points must be observed: If under all'-conditions the so-called sputum contained only tubercle bacilli of the patient in question, the con­ duct of these experiments would be rel­ atively simple. But every one who has examined sputum under the microscope knows that it is mixed nearly always with particles of food. These of course may contain milk and butter which themselves may harbor tubercle bacilli derived from cattle. I consider the ex­ perimental error caused thereby of such significence that only those ^xperiments on the occurence of the bacillus of bo­ vine tuberculosis in sputum can. be re­ garded as conclusive from which this error has been absolutely excluded In order not to be misunderstood on this point, which is to me .of paramount im- =Ofti.Kr, may I be arntwea to give tne following illustration? The British Commission which is en­ gaged in the investiisation of the relation Setween humln and bovine tuberculosis, has conducted experiments on he feed- feig of phthisical sputum to cattle x t x x The sputum of only one definite consumptive should be fed to one den­ ote animal. Obvieusly, care should be taken that the patient in question re­ ceives during the experiment neither milk nor butter, x x the experiment must be so arranged that it can be repeated from time to time with the sputum of the same patient. The experiments carried on at tne fUiaerliche Oesundheitsamt in Berlin are Hie only ones which fulfill In ev­ ery way the foregoing experimental re­ quirements. Those of the British Com­ mission fail In several respects, and all other work which has come to my no­ tice answers these requirements so poorly that 1 can grant them no weight, as least as regards the occurrence of bovine tuberculosis in man. x x Many of my opponents have made strenuous efforts to prove that the tu­ bercle bacilli in man and those in cat­ tle cannot be of different species, and {they imagine that they can thus re­ fute my contentions. This, however, Is a perfectly useless endeavor. I have never held that we are dealing with two distinct species, but have only,, stated that they differ from each other in certain characteristics, characteristics which are of the greatest tmportunce in combating tuberculosis. Whether these differences Justify us In speak­ ing of special varieties or evep species is. from my point of view, quite irrele­ vant. I am concerned, as I have pre­ viously stated, only with the practical signlficence of the differences between human and bovine tuberculosis, x x Others of my opponents ha\e attempted to refute me by showing that the bacil­ lus of the human type may be transform­ ed into the tubeicje bacillus of the bovine type, and vice versa, by passages through animals or by cultivation un­ der artificial conditions, in this con­ nection I can merely repeat that I am interested only in the practical signifi­ cance of the difference between the tWa types of tubercle bacilli. For our piirpflsp. that is, for combating tuber­ culosis, it is absolutely without signific­ ance what changes tubercle bacilli will undergo after being passed through a series of animals or during cultivation under some artifical conditions. Those men who consume milk and butter do mot bold back aad sake cultural ar Mi* mal experiments: tliey eat them la the fresh, unchanged condition. In my j opinion, therefore, we are cone rned ! here with the properties of the fresh j and i'n"hangpd tun. rcie bacillus onlv. I «o not deny that cultural tran f -r.. a'ions! may be made with tuese an well as with other bacteria, but this is a ques­ tion of purely theoretical value. I shall ' ^tnerefore lay it aside. j We may now take up the results of | recent investigations. I believe that what has come to.,.my knowledge so far m a y b e s u m m a r i s e d b r i e f l y a s f o l l o w s ' Ail conpetent investigators agree that 1 the tnbercje bacilli of human origin dif- ! fer from the . tubercle bacilli of cattle, ! and that, consequently, we must differ­ entiate between a typus hum#m;s ivnd * typus bovinus. The British •Commis­ sion also admits the existence of tl.^ss aifferepces. but as some of their cul­ tures showed definite changes In their characteristics after passage through animals and various cultiva'ons, they hav^ differentiated a third group. wMch they call "unstable." As 1 have repeatedly emphasized, it is not of the sligl test Im­ portance to us whether, after animal inoc­ ulation or breeding experiments, tlie tu­ bercle bacillis is stable or unstable. What concerns us is behavior in the fresh condition. I am therefore unable to ac­ cept this third group of the British Com­ mission. and I am satisfied with their admission that the fresh tubercle bacilli of the human type differ distinctly from those of the bovine type. The tubercle bicilli of the human type are characterized by the fact that they Siow rapidly and abundantly in a thick layer on glycerin serum. They are viru­ lent to guinea-pigs, slightly virulent to rabbits, and almost non-vlrulent to cattle. The tubercle bacilli of the bovine type prow very slowly and in a thin layer on glycerin serum; they are of equally high virulence to guinea-pigs, rabMts, and cattle. To my knowledge, the ba­ cilli of the human type has never been demonstrated in cattle. The bacilli of the bovine type, on the other hand, can occur In man. They have been found i« the cervical lymph- glands and in the intestinal tract. With few exceptions, however, these bacilli are but slightly virulent for man and remain localized. The few known cases In which the bovine tuberculosis is said to have produced a general mcl fatally progressive tuberculosis in > .an appear to me not to be above suspicion. No special proof is required If I say that these results constitute the confir­ mation of the statements which I made at the London Congress. In closing, I have still one point to discuss which seems to me of high im­ portance. Of all human beings who succumb te tuberculosis, eleven-twelfths die of con­ sumption or pulmonary tuberculosis, and only one-twelfth of other forms of the disease. One would have expected, there­ fore, that those investigators wlo are Interested in establishing the relations between human and bovine tuberculosts would have searched for bacilli of the bovine type preferably in cases of pul­ monary tuberculosis. This, however, has not been the case. Evidently ani­ mated by the desire to bring together as many cases as possible of bovine tuberculosis in man, they have investi­ gated particularly caSes of gland and Intestinal tuberculosis, and have neglect­ ed the much more important pulmonary tuberculosis. In spite of the bias under which the researches hitherto have suf­ fered, there yet remains at our disposal a sufficient number of investigations of pulmonary tuberculosis to warrant provisional expression of opinion. The R-ist of it is--and I beg you to take note of it--that, uptodate in no case of pulmonary tuberculosis has the tu­ bercle bacillus of the bovine type been definltelv demonstrated. If, on further Investigation. It should be established that pulmonary tuberculosis is produced by the tubercle bacillus of the human type exclusively, then the question will be decided In favor of the view which I have upheld, and we must direct our regulations for combating tuberculosis by all means primarily against the tu­ bercle bacilli of the human type. On account of the great importance of this question I Intend to undertake as soon as feasible experiments along this line on a broad scale. At the same time I wish to make my plea, to other tuberculosis workers, in order that as many cases as possible may he exam­ ined, to join with me vigorously in this task. But I wish to lay stress on the fact that the conditions laid down by me for the carrying out of these investi­ gations must be followed. I consider it quite possible that in this manner the essential facts for deciding this im­ portant question may be collected in about two years and be presented to the next International Congress.'* and quoting his statements from pages 741 to 756, inclusive, Volume 4, Part 2, Section 7, same Conference, as fol­ lows : "The Conference on the Relations of Tu- Mrenlonii of Animals and of Man," at the New WIIlard Hotel, WsshiBgtr.it, li. C., Thursday, October 1, 1908: Continuing th« Joint Session of Section I and Section VII. (In Camera.) "Dr. Herman M. Biggs (New York): It is understood by {ill of you that this conference was arranged at the sug­ gestion of Professor Koch, for the pur­ pose of discussing somewhat informally and privately the questions of the con­ nection between human and bovine tu­ berculosis which are of such enormous theoretical and practical importance; and it is the understanding that what is said here is simply for the informa­ tion of those who are Interested in this work and in the bacteriological prob­ lems involved. I hope all those who are present will keep this in mind, x x Prof. Koch: A great difference of views seem to prevail with regard to the question of human and bovine tu­ berculosis, and I am glad that, we have an occasion to enter into the subject la detail, x x I would especially propose two point* tor discussion, the first referring to the remarks of Mr, Fibiger. who contends that bovine tuberculosis is very frequent in man. I wish to state again on this occasion that I have never denied that bovine tuberculosis is found in man, but I contend that these cases are rare, Secondly. I would refer to the state­ ment I made on Wednesday last in the Congress to the effect that not one single authentic case of phthisis has ever been found in man where for any long period of time bovine tubercle ba­ cilli have been coughed out by the pa­ tient. 1 would specially ask the ques­ tion whether any case of pulmonary tu­ berculosis exists in which tubercle ba­ cilli of the bovine type were found, not once, but repeatedly. I propose that we should discuss this second point first, and I ask: Hat anv* one of the gentlemen present ever seen such a case of bovine tuberculosis in man' (Pause.) It appears that no­ body knows of such a case. The Ger­ man Commission for research--that much is known to the members present-- fo-ind no such case among 22 cases inves­ tigated. x x The Chairman: Is there any one here who can report such a case as Profes­ sor Koch has ask^n for' Prof. S. Arlolng. (I^yons, France): I claim to have identified such a case, or discovered such a case in which the bovine bacillus was isolated. An au- topsv was performed, and in a cavity thf* tubercle bacillus was found, and a culture made from it which possessed all the cultural characteristics of the bovine tubercle - bacillus, and which, when injected into an animal of the bo­ vine species. produced a generalized tu­ berculosis. Prof. Koch: The case on which Pro­ fessor Arloing reports and his conten­ tions are known to me. but the finding of a single case of bovine tuberculosis In a cavity cannot be considered as proof: the case would only show proof if the bovine tubercle bacilius had been found repeatedly and during a cer­ tain period of time. In this connection 1 would call attention to the possibil­ ity of accidental contamination with milk or butter or other food substances, which must always he kept in view; even if the bovine tubercle bacilli are found in a cavity after death, the possi­ bility must always be thought of that th" "patient, in the course of I is last hours of life, mav have inhaled oarti- cW of vomited contents of the s'rvnach or contents of the mouth cavity, and that the infection of a tuberculous ca- Tttr with the ho vina tjp# msf come to pass in that way. One Isolated observation of this kind has not the necessary power of ptooi, and only ex­ periments of utmost exactness, and ex­ cluding every possibility of secondary contamination, can be taken into ac­ c o u n t . x x x Prof. a. Arloing: I know that Profes­ sor Koch accepts the realitv of the finding of a large number of bovine bac:lli in the lung, but he believes that this mav have occurred by contamina­ tion from food, x x Prof. Koeh: There seems to be a mis­ understanding between Professor Ar­ loing and myself. I do not doubt that he has found the bacilli of the bovine type in the 1 ng\ l ut this is enlv an isolat* ed case. 1 repeat that we may be deal* •ng; here with an accidental admixture. Prof. S. Arloing: I admit that my re­ searches were net strictly in conform­ ity with all the requirements of Profes­ sor Jvoch--that is. constant and prolong­ ed research in this matter- but these bacilli were found during the life of the patient, and, then fore, precluded the supposition of Professor Koch that the occurrence of this infection was at a moment of asony. I wish to repeat that the multiplication of these bacilli in the tissue siiows adaptability of human tis­ sue to the bovine bacillus. Prof. Theobald Smith (Boston): The question before us is one of methods. In the study of the tubercle bacillus with special reference to its differential characters we would hardly apply the same methods today which we apt.lieu ten or fiftet n years ago. Now we must determine not onlv whether the bacilli associated with a certain disease are bovine or human, but we must gusrd against being deceived by mixed cul­ tures or by the accidental pi-eserice of one or the other type. I think the de­ mand made by Professor Koch a rea­ sonable one. In the final determination of bovine tubercle bacilli as a cause of pulmonary tuberculosis there should be repeated examinations of the same case, to find out whether the bovine bacilli actually multiply tftere and continue to be thrown off in sputum, x What has been reported thus far can only be considered presumptive. The presence of large numbers of bacilli in the lungs, In the case mentioned by Professor Ar­ loing. cannot be safely used as an ar­ gument. because thev mav have been human bacilli admixed Willi a few bo­ vine by accident, as Professor Koch points out. We know that there are hu­ man bacilli of such low virulence toward guinea-pigs that they may be lost af­ ter inoculation and onlv the virulent bovine, type persist. Finally, the diffi­ culties and pitfalls surrounding the bac­ teriological study of diseased organs ia open communication with the air and the digestive tract are well known. The study of lymph-nodes presents fewer dif­ ficulties. Prof. Fiblger: I would ask whether Professor Koch remembers an authentic case of bovine tuberculosis in man which is described by Dutch authors. Prof. Koch: T know that case very well. It is a case of this type: but it has the defects which have been inher­ ent in the earlier Investigations. Be­ sides, the same objections apply to this case as to that mentioned bv Professor Arlolng. vi*., that the case represents but one sinele finding. In order to ar­ rive at definite conclusions, the great­ est care with reference to the conditions stipulated by me must be taken In fu­ ture in all cases investigated and re­ ported. T do not consider this question as settled either in one sense or in the other, before all Inexact cases which are unsuitable for proof are absolutely cleared up. The Chairman: Unless £here 1^. ob­ jection. we will now pass on to the con- consideration of the second question, and I will ask Professor Koch to speak Prof. Koch: I would ask the follow­ ing ouestion: How often does primary Intestinal tuberculosis or tubeiculosis of the mesenteric glands occur in children? It has been said bv some that primary Intestinal tuberculosis occurring in chil­ dren is due to bacilli of bovine tuber- losis. I contend t! at tl is form of tuber­ culosis is not frequent, and In support of this assertion I r-'fer to Virchow, Orth. Albrecht. Batimearten. f.nd others as authorities who have said, and s-till say, that primarv lntcst:nal tuberculo­ sis is an extraordinary rare disease. (Professor Koci: rend the following pas­ sage from the news' work of C. Plugge, "Die Verbp'itungfweise und Bekamp- fung der Tnbe*'kiiose atif Grund experi- mentaler Untersuchung' n im hygicnts- chen Institut d r Koniel. Trnl>-»r^Itai Breslau."--"The Kxperimental R. srarches Carried out at the 'Tyarenic Institute of the lioyal University of Br.^slau," 1908. t>. 431. 'If some few authors are of a dtffeiv ent view and Fib'g^r and Jensen. "W instance, find primary intesM«al tuber- culosls in the on so of alxvit 6 ner ef ail patients, and of about IT percent of all tuberculosis patients and in chil­ dren even of lfi per cent. Baumgaiten considers this figuiv 'as far too high, and savs:-- •Primary intestinal infection is very rare, according to mv « x^r'onop. flnn most pathological anntoivlf'ts agree vth this view.' Virchow. Or'h ttibberr. Albrecht, and manv others 'rive express d their opinions to aulte the s«me effect. Orth found among 131 children orly 1.5 per cent of unquestionall" tuberculosa of the Intestinal nnd mesenteric glands; Bledert. among 3104 sections of tuber­ culous children, found primary intestinal tuberculosis 18 times, i. e., 5 cases in lOOfl. BHginsky found no cases In 933; Grosser onlv one case among 1407 sec­ tions of tuberculosts in the Pathologic Institute of Tubingen.' , Thus it Is seen that the view* of the pathologic anatomists widely differ from each other. I have discussed the oues­ tion with Orth among others: his per­ sonal view certainly differs from that of Heller's assistants, as far as autop­ sies in Berlin are concerned. I would now ask: Whence comes this great difference? Ar-j there local dif­ ferences in the pathological material of the various localities, or must the dif­ ference of optrvon lie looked for in the gub e tlve und rstaiding or subjective Interpretation on the part of the var­ ious piosectors and pathological anato­ mists wlo carry out the autopsies? This question remains undecided. The question' or the frequency of primary in­ testinal tuberculosa I cons'der settled thus far. that, in mv opinion and in that of other authorities, the occur­ rence is verv rare. If we consider that eleven-twdftl s of the tuberculous deaths are due to pulmonary t;iberci.log's and only one- twelfth Is caused by all the other forms Of tuberculosis together; if we tak^ into account that, of these again, only a small part e«n be due to primary intestinal tuberculosis, and that, once more, only a smnll part of them belongs to bovine Infection, we must admit that bovine infection |s a rare clinical occurrence. Prof. Woodhead: T must say that when Professor Koch stated It) London that primary feed'ng tuberculosis was very rare and actually seldom or never occurred-- Prof. Koch: I said It was rare. Prof. Woodhead: Dr. A. Calmsstte: Prof. Tendeloo: Prof. J. Fiblger (Copenhagen): Prof. Koch: Notwithstanding I am not convinced. The result, so far ascer­ tained. is that some pathological anato­ mists sav that the figures are high and others that they are low. 1 am of opinion that the cases of primary me­ senteric tuberculosis are rare, as also results from tl'i* considerable amount of information tendeied just now by Pro­ fessor Tendeloo. The question Is not, how many cases of primary intestinal tuberculosis are found? but. how many cases thereof are due to the tubercle bacillus of the bovine type? I refer to the statistics published by Oaffky, who in the course of the last two years examined 300 children that had died In the hospital of Bit.glnsky. whom Mr. Fiblger refers to as having gradually brought out higher figures tkiu form­ erly Among the cases mentto*j|f in the above statist s there were |L >1- aths f r o m t u b e r c u l o s i s , w h i l e • a > y w e r e doubtful: among ttu>se L3 cases there was not a single case of bovine tuber- uclo^is the patients ha vine all been victims to human tuberculosis. Should this sprcial diffuvm-e Perhaps be ex­ plained by supposing that there is less be hie tuberculosis In fterlin than in Copenhagen» This question must for the present rema n undecided. As regards tbo view expressed by Calmette. I have e-tweted long sine* that somebody *""ld put forward the argument that the bacilli c' unue their character on the nay from the mesen­ tery to the lungs. But this, gentlemen, la a mere !iyr>or'i-s's. supported by nothing. Ob Ui«. j-ontre.rr. everything we know at Pf':ertt on tills sub'ect speaks a.rii!rs<t the •'hypothesis; for it is a provud fact t at the bovine tuber- «« DacUiuft-, ttp otwu»ci«r.. f«r ft •fry Ion* time. I have repeatedly fount •virulent bovine tubercle bacilli in oid, healeti-up. strictly localized, and partly calcified glands where these bacilli must nave remained capable of life for a very long time. I have likewise had occasion repeatedly to examine typical wart-like swellings on the hands of workmen em- Ployed in the slaughter of tuberculous cattle. Even where such nodul-s on the fingers of the patients had existed for years, bacilli of the unmistakable bo- vine type could be isolated for them. Considering the great confusion wuich apparently exists with regard to the whole problem in question, I would urgently warn against inferences from a hypothesis which is absolutely un­ supported. xx Prof. j. G. Adaml (Sitontreal): We nave now heard the opinions of work- ers m the various countries regarding the existence of Infection by bacilli of tne bovine type. But t .ere is a mat­ ter that may be brought forward, and i wish to propound this question to His Excellency. Professor Koch: in l is ad­ dress before the Congress on Wednes- ^fu'rno<m he stated emphatically tnat he confined liitns. If to practical rather than to theoretical matters, ami promised that during the next two or three years he would devote himself to the study of the incidence of the ba­ cilli of the human or bovine type in cases of pulmonary consumption. Grant­ ed lie does this, and suppose at the end of two or three years he finds-- as for myself. I am fairly sure that he will find--tb.it practically all cases of pulmonary t»!*idsls In men are due to bacilli of t:.e human type, I -would ask the question,-: What practical use is there in the investigation arid in this delay? For at the end of the period we shall still be confronted with the problem of the eradication of tubercu­ losis in cattle, and that because, as he has admitted here and in London, a certain proportion of cases of the dis­ ease in man. though not of the pulmo­ nary tvpe. are due to the bo v ine bacil­ lus. It seems to me. Mr. Chairman, rather unfortunate that both here and In London. Professor Koch did not take up the other point which lie 1 as empha­ sized. namely, that so far not a single case is known in which the human type of bacillus lias been found in the bo­ vine oiganism under natural conditions, and. experimentally, only when we mod­ ify the conditions and use mixed cul­ tures. Here, as I pointed out two years before Professor Koch's London pro­ nouncement, is a matter that is emi­ nently practical; for if this be admitted, then it is possible to eradicate bovine tuberculosis, even when we take no ade­ quate steps to eradicate the human type in man. Granted that human and bovine cases coexist in a locality, the human tvpe will not. under ordinary conditions, give the d'sease to cattle. Why not take up a line of work the result of which must be of Immediate utility, rather than one which must, when concluded, leave us at most where we started? i Prof. Koch: I would again call atten­ tion to the fact that human tuberculosis Is the principal point of attack, because eleven-tw» Ifths of the patients parish through this type of the Infection. I ad­ mit that bgvtne Infection can occasion­ ally occur, and 1 desire not to be un­ derstood as disregarding the endeavors to extirpate bovine tuberculosis, as far as these endeavors are dictated by ag­ ricultural and economic reasons. But 1 mean that it would be wrong to give to these proposals the loading place in front of the efforts to comhat human tuberculosis. Prof. Fiblger: Professor Koch h t •• claimed that a great many of my fig ures especially apply to cases that were selected. This I denv. Tliey were not •elected. The results or Oaffky. to which Professor Koch refers, are not complet­ ed. nor have they to my knowledge been published. I can refer, so far as the other point is concerned, to the publications of Kl»ine. who reports two cases of hand infection in which bo­ vine bacillus was found. Prof. Koch: 1 object to the interpre­ tation of this latter finding, as it is evidently not conclusive in any respect: for we might be dealing here with cases of infection by human bacilli, as we frequently find them, in the shape of primary lesions, w'th pathological anat­ omists. In that case, such a finding differs very much from the cases men­ tioned by myself, where very virulent bovine tubercle bacilli were found in primary tuberculous lesions after many years. The Chairman: It doea not seem to me that we are very far apart. -We have -human and bovine tuberculosis, both of which are of groat importance. There is no question but that the vast majority of casts of human tuberculo­ sis are due to hum&n bacilli. There is a small proportion which are due to either the human or bovine bacillus. The only difference of opinion seems to be with regard to the question as to how large a percentage of that residuum Is due to human infection or is due to bovine Infection, and the question comes up: Is it possible to arrive at any kind of conclusion in a resolution which will put in form the feelings of the mem­ bers of this conference in regard t® this ouestion? 1 think that is what should be considered in the few minutes left at our disposal, x x Prof. Koch; Gentlemen, we are deal­ ing here with a purely scientific sub­ ject, and the Questions proposed can­ not be settled by any resolution. We are speaking of objective facts and not of subjective views. X for my part most earnestly refuse to loin in any resolution on- this subject. Prof. Woodhead: " I)r. Eastwood (London): Prof. Koch: We have not at all dis­ cussed this subject; how can resolutions of purelv practical importance be brought about in this meeting on things which we have not discussed today? I re­ peat 1 ah all abstain from any resolu­ tion. Dr. Pearson seconded the motion ef Eastwood, and pointed out that, accord­ ing to the general impression, Koch has estimated (iti 1901, in London) the transmissibility of bovine tuberculosis to man so low that measures against bo­ vine tuberculosis would be without im­ portance to tlie pubiic iieairn. if, as Fibigor has explained from the statistics of Baginsky. the cases of primary In­ testinal tuberculosis have considerably increased in Berlin since then, the oues­ tion would have to be asked whether any neglect of precautionary measures in connection with the consumption of milk has occurred, in consequence of the' London statement. A lengthy discussion ensued, in which Messrs Flick, Smith. Kavenel, Arloin* and Fastwood took part, on the auestion wlietlier and how tt)« rp«ulti of conference are to be brought before th^evera\U orators pointed out the necea sitv to publish some Account of tne session. Finally, it was proposed to place the shorthand minutes before the public. Prof Koch: I have not the slightest objection to the publication of an ex- • <-t report of this meeting. W hy should f obiect to the statement that 1 recog­ nize the transmissibllity of bovine tu­ berculosis to man' I have never de­ nied it I propose, therefore, that a report shall be published after tha shorthand notes have been seen and signed bv each speaker, but the report Is onlv to be a mere reproduction of the spoken word, of the facts stated and. of opinions expressed, and is in no way to take the shape of any resolution, especially not on any questions which we have not discussed. Tii is arrangement proved acceptable, and after Its adoption tlie meeting ad­ journed. This contains in substance all that Professor Koch said at Washington • year ago upon that subject, from th« substance of all of which it seems that Professor Koch still persists In the belief that boviqe tuberculosis ia an economic and agricultural question only, and not one that pertains to hu­ man health. Also in th® Journal of^ the Ameri­ can Medical Association "under date of October 10, 1908, is an editorial discussing the subject, and speaking of Professor Koch says; "Professor Koch, in the eyes of the public, stands as the great authority on tuberculosis and his views there­ fore carry enormous weight with the ordinary layman.Bu: the editorial regards, in substance, that his posi­ tion taken in 1901 is again assert­ ed in 1908. EDWARD D. SHUKTUEF!*, . 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