Review of the Tuberculosis Situation

Re Milk Transmission of Bovine Tuberculosis to Human

Beings

By M. P. Ravenel, M. D., Columbia, Mo.

Mr. Chairman, Ladies and Gentlemen, I must begin by a disclaimer of this title which our very efficient Secretary has given this paper, because if I tried to give a review of the entire medical situation during the past year I am afraid I would talk a good deal longer than any one here would be willing to sit and listen. The real title of the paper-with all apologies for calling attention to this dereliction on the part of our very worthy Secretary-should be, "A Review of the Tuberculosis Situation in regard to Milk Transmission of Bovine Tuberculosis to Human Beings."

The report is usually a very short one, and this year will be shorter than usual, because owing largely I think to the European war there has been less work done; and if there is any good coming out of this war it is that it has cut off the volumes of hot air which are usually sent forth on this subject from various parts of the world; so that there are but two papers to review. One of these was mentioned in my last year's report, that of Dr. A. Philip Mitchell of Edinborough, continuing the work done by Dr. Stiles and Mr. Frazier, who are working particularly on surgical tuberculosis, whereas, Dr. Mitchell has taken up scientifically gland tuberculosis.

In 72 cases examined by Dr. Mitchell 65 or 90 per cent. of those cases were shown to be of bovine and 10 per cent. only due to human origin. Further investigation of these cases showed that 84 per cent. of these cases had been nourished on cow's milk, unsterilized and uncertified, from birth.

The second paper is one which I have a little hesitation in quoting, although it accords with my well-known views entirely, simply because I think that the man that makes it does not study as carefully as he should. I say this with all due respect to him. In this paper he claims to have investigated instances of bovine tuberculosis in various parts of the country where cow's milk is not used to any great extent. I find that according to his report that while phthisis and the various forms of human tuberculosis are quite common in this country and some of them

on the increase, that there is little or no surgical tuberculosis; it being a well-accepted fact at the present time that the bovine tuberculosis bacillus in the human being produces all the various types of surgical tuberculosis, bone, cervical, spine and joint tubercle. In view of the intertransmissibility of the two germs this has been very freely acknowledged.

This report shows further that in England phthisis of various forms, human tuberculosis, for the last fifty years and various forms and types of mesenteric and surgical tuberculosis have increased to a very considerable extent.

Coincident with the increase of bovine tuberculosis in English territory it is well known to everybody who has studied the question that until the year 1901, England had practically no laws regulating bovine tuberculosis whatever; so that these observations are distinctly in line with what was known to us in this country.

One other thing I must mention, and that is, that in consideration of the general movement that we are talking about, the National Milk Commission appointed by the New York Milk Committee have taken up the question of recognizing the danger of bovine tuberculosis which is universally recognized at the present time so far as I know. They have taken up for consideration recently the classification of butter and ice cream, two very important milk products, in order to guard the public in their use of ice cream and of butter; also from the bovine tubercle bacillus which is found in milk.

I thank you very much.

President McCleave: Has any one anything to add to what Dr. Ravenel has said? Is there any discussion of Dr. Ravenel's paper?

Discussion

Dr. J. P. Sedgwick, Hennepin County Medical Society, Minneapolis: It may be interesting to the organization to know that in Minneapolis two years ago Dr. Larson and I reported on the bacillus abortus in its relation to children. We have been working more on the subject during the past two years. We have not been able to find any reactors among new-born

children that have had breast milk only. In connection with this same character of work we thought we had found one which was in the new-born ward, and we looked back and found that the child had been taken from the breast because of the illness of the mother and had been fed upon a preparation containing cow's milk. So that I think that is another link in the chain of proof as to the possibility of carrying something from cow's milk that is not proper for human beings. We found in those cases also that where we found reactions in large numbers that the herds were affected with abortion of cattle.

President McCleave: It would be a wonderful thing if this Association should find another cure for tuberculosis, because of our activities that will be cheaper than some of the others.

President McCleave: Dr. Coit, have you anything to tell us on this subject?

Henry L. Coit, M. D., Essex County, N. J.: If we are going to solve this problem we must be ready to define tuberculosis. We will have to encourage practical, as well as scientific effort, and a good deal of scientific effort must be dubbed ultra-scientific. If we can supplement the scientific by practical effort we are going to get some results. Mr. Francisco states that he has expended $1,700.00 for the services of three men for less than ten days. Mr. Francisco is here. He is a dairyman and producer and says he has made expenditures amounting to $2,500.00 for thermometers and for veterinarians, railroad expenses and material, all connected with the practical features of this investigation. Let us honor the producer for his willingness to help us carry on these practical efforts solving our problem in the protection against tuberculosis.

President McCleave: I want to congratulate Mr. Francisco on having $2,500.00 this year. I think that beats doctoring, out in the West anyway. We have not seen any $2,500.00; but we do most sincerely congratulate Mr. Francisco on the way in which that disagreeable situation was handled. I think we do owe him a great deal of credit for the manner in which he did what was demanded of him at that time. But the fact still remains that he had $2,500.00 this year!

I think we will have time for one more paper before adjourning for luncheon, "Dairying Conditions in Southern California"

by Geo. H. Hart, D. V. M., the Veterinarian of the Los Angeles County Commission.

By request of Dr. McCleave, Dr. Adelaide Brown now took the Chair temporarily.

Geo. H. Hart, V. M. D., Los Angeles County Commission: Mr. Chairman and Members of the American Association of Medical Milk Commissions, I have not confined my paper entirely to the question of uncertified dairies, as I understand that a great many of the members of this Commission are interested in the general milk problem.

Dr. Hart then read his paper, as follows:

Dairying Conditions in Southern California

By Geo. H. Hart, V. M. D., M. D.

History

When California became a part of the United States in 1848, following the Mexican war, the entire country was very sparsely settled and cattle in considerable numbers were raised on the open ranges. These cattle were the so-called SpanishMexican, or native cattle, and were of very inferior type and of no value for dairying purposes. When the eastern settlers came across the plains to settle the country, it was a common practice for from one to four or five milch cows to be included in the camp outfit to act for the dual purpose of furnishing milk and hauling the camp wagon to relieve the oxen.

Mr. J. B. Durfee, an old settler living a few miles from Los Angeles at the present time, came across in this way in 1855, and brought fourteen head of stock with him, four of which were milch cows.

About 1852, a band of Mormons migrated from Utah and settled in San Bernardino. They brought dairy cattle with them from the original colony, which, at that time, comprised the best dairy cattle west of the Mississippi River.

The San Francisco Bay region becoming the business center of the coast, the population grew most rapidly here and with it the dairy industry. The early growth of the industry in the southern part of the State was very slow on account of the scarcity of population. In 1870, the first railroad came into California and this was soon followed by the importation of better grades of cattle than had been driven across the plains in the early days.

The first pure bred Jersey cattle were brought into Southern California in 1878, by Barretta of Downey. The first pure bred Holsteins to come to the country were a carload shipped in by the New York firm of Smith, Powell and Lamb, in 1885. These shipments of Jersey and Holstein cattle were the beginning of the improved breeding of the scattering dairy herds.

In 1880, Los Angeles had a population of only 11,000 people, but in the boom years of 1884 to 1887, the population rapidly increased to 75,000, which gave impetus to the dairy industry.