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37
THE ROYAL COMMISSION ON TUBERCULOSIS.
At the International Congress held in London in 1901, Professor Koch read a paper in
which it was stated that bovine and human tuberculosis not being intercommunicable, the
ingestion of the milk or the flesh of tuberculous cattle involved no practical risk of the transmission
of tuberculosis to man. This view was vigorously controverted, and at the final meeting
of the Congress the subjoined resolution (No. 5) was unanimously passed—
" That iu the opinion of the Congress, and in the light of the work that has been presented at its
sittings, medical officers of health should continue to use all the powers at their disposal, and relax no effort
to prevent the spread of tuberculosis by milk and meat."
A further resolution (No. 6) was adopted, viz.:—
" That in view of the doubts thrown on the identity of human and bovine tuberculosis, it is expedient
that the Government be approached and requested to institute an immediate inquiry into this question, which
in of vital importance to the public health and of great consequence to the agricultural industry."
A Royal Commission was appointed shortly after the close of the Congress.
It having been suggested, by interested parties, as a result of the publication of Dr. Koch's
views, that the stringency of procedures intended to prevent the sale for food of man of the milk cf
tuberculous cows, and the flesh of tuberculous animals, should be relaxed, the Local Government
Board, in a circular letter to Sanitary Authorities, advised that, pending the investigations and
report of the Royal Commission, there should be no relaxation on their part, or on that of their
officers, in the taking of proper measures for dealing with milk from tuberculous cows, and with
tuberculous meat which may be intended for the food of man.
The Royal Commission, appointed in August, 1901, was instructed to inquire and report—
1. Whether the disease in animals and man is one and the same ;
2. Whether animals and man can be reoiprocally infected with it;
8. Under what conditions, if at all, the transmission of the disease from animals to man takes place,"
and what are the circumstances favourable or unfavourable to such transmission.
In a second Interim Report issued last year, the Commission submit "a detailed account of
the results very briefly stated in the Interim Report of May, 1904, and of the progress which has
since been made in the inquiry." In the concluding paragraph of this report " the bearings of the
results " at which the Commission have already arrived, are summed up ; it being stated that—
" There can be no doubt but that in a certain number of cases the tuberculosis occurring in the human
subject, especially in children, is the direct result of the introduction into the human body of the bacillus of
bovine tuberculosis ; and there also can be no doubt that in the majority, at least, of these cases, the bacillus
is introduced through cows' milk. Cows' milk containing bovine tubercle bacilli is clearly a cause of tuberculosis,
and of fatal tuberculosis in man."
The facts ascertained in regard to cases of human tuberculosis investigated, " indicate that a
very large proportion of tuberculosis contracted by ingestion, is due to tubercle bacilli of bovine
source," " introduced through the alimentary canal" ; and the conclusion is drawn that—
" A very considerable amount of disease and loss of life, especially among the young, must be
attributed to the consumption of cows' milk containing tubercle bacilli."
The Commission state that—
" The presence of tubercle bacilli in cows' milk can be detected, though with some difficulty, if the
proper means be adopted, and such milk ought never to be used as food," and that " there is far less difficulty
in recognising clinically that a cow is distinctly suffering from tuberculosis, in which case she may be
yielding tuberculous milk," and that " the milk coming from such a cow ought not to form part of human
food, and indeed ought not to be used as food at all," and that their " results clearly point to the necessity of
measures more stringent than those at present enforced being taken to prevent the sale or the consumption of
such milk."
In the conclusions thus arrived at by the Royal Commission, ample justification will be
found for the desire of the London County Council for increased powers for preventing the spread
of tuberculosis through the agency of milk.