Chapter 50

Practically all the animals that react are affected with tuberculosis and should be separated from the herd, not only in the interest of the public, but in the interest of the owner of the herd. The best authorities admit, after studying many thousands of tests, that there are few, if any, mistakes made in condemning cattle which show a typical tuberculin reaction. The errors are principally in the other direction--that is, some tuberculous animals are not discovered by the tuberculin test, but as the most dangerous of these may be picked out by ordinary clinical examination this fault of tuberculin is not so serious as it at first sight appears. This being the case, it should not be necessary to force the tuberculin test upon owners. They should be anxious to adopt it in their own interests and for the protection of their patrons. There is to-day no greater danger to the cattle and hog industries than that which confronts them in the form of tuberculosis, a disease already widespread and rapidly extending. Furthermore, in view of the results revealed by numerous tests covering vast numbers of animals, tuberculin must be considered as harmless for healthy animals. It has also been clearly demonstrated that tuberculin interferes in no way with the milking function in healthy cattle; neither in the quantity of milk nor in butter-fat value has any variation been detected. The conclusions of some of the best authorities on the subject of its harmlessness to healthy animals are given below.

Nocard and Leclainche state:

Direct experiments and observations collected by thousands show that the tuberculin injections have no unfavorable effect. With healthy animals the system is indifferent to the inoculation; with tuberculous animals it causes slight changes which are not at all serious.

Bang has written as follows on this question:

We will now consider the following question, a very important one, in the application of tuberculin, viz: Can the reaction produce a worse condition in tuberculous animals than before existed? Hess emphatically states that it can, and on this account he earnestly warns against its application. My attention has been directed to this question from the beginning. In my first publication on tuberculin injection I reported two cases in which acute miliary tuberculosis was proved in two high-grade tuberculous cows several weeks after the tuberculin injection. I then stated my suspicion that perhaps the tuberculin injection had some connection with this, just as is often supposed to be the case in human practice. With my present very large amount of material for observation at hand I may express the following opinion: Such an acute development of tuberculosis as a result of tuberculin injection is to be feared only exceptionally, and then in cases of advanced tuberculosis. _It must not be forgotten that acute miliary tuberculosis by no means rarely accompanies an advanced tuberculosis of long standing._ It is therefore impossible to offer strict proof of the causal connection with the injection, and only oft-repeated observation could make this probable. In support of my view I offer the following: In the course of the last three years I have made careful post-mortem examinations of 83 tuberculous animals, which have been removed from my experiment farm, Thurebylille. Among these were 18 (or, strictly speaking, 23) high-grade tuberculous animals. I have been able to prove miliary tuberculosis in only 4 of these. Among the others, which showed less developed tuberculosis, I have never found miliary tuberculosis, and with very many I have never found any sign of a more rapid development of the process. On the contrary, it has been proved that the disease was restricted locally, often for years, in spite of yearly repeated injections. Dissections were made at very different periods after the injections--in 17 cases from 4 to 12 days after the last test. In all of these cases earlier tests had been made months or years before. In 28 cases the injection took place from 19 days to 2 months before the butchering; in 3 of these cases earlier injections had been made. In 38 cases from two and one-half months to one year intervened between the last injection and the dissection. Dissection gives the best explanation of this question, but a clinical observation, continued for years, of a herd tested with tuberculin can render very essential aid. If Hess's opinion is correct, it is to be assumed that tuberculosis must take an unusually vicious course in such herds, but this I have been unable to prove. At Thurebylille there has existed for three years a reacting division, consisting originally of 131 head and now 69. Although these animals are yearly tested, and although most of them react every year, the division certainly appears to be made up of healthy animals, and the farm inspector has expressed the decided opinion that the tuberculosis in this division is no more developed than at the beginning of the experiment. The testimony of many owners of large herds of cattle which have long ago been injected is to the same effect. I will adduce statements from several. A farm tenant whose cattle were injected 20 months previously, when 82 per cent of the grown animals reacted, wrote me recently as follows: "Only 2 cows from the division of 100 head had been sold as decidedly tuberculous. The majority appeared afterwards, just as before, entirely healthy. The fat animals which had been slaughtered had been pronounced healthy by the butchers." Another farm tenant with a herd injected in 1894 had not been obliged to remove a single animal from the tuberculosis division, numbering 70 head. A large farm owner in Jutland stated in September that he had traced no undesirable result from the injection. His herd of 350 had been injected in February and about 75 per cent reacted. Similar answers have been given by other owners and veterinarians.

A veterinarian who had injected 600 animals, among them a herd of a large farm, 18 months previously, expressed the belief that the injection had produced in no single case an unusually rapid or vicious course of tuberculosis. In spite of a demand made months ago, I have received thus far no report from any veterinarian of an undesirable result.

On a large farm, on which before the injection tuberculosis had appeared in a vicious form, the owner had the impression that the severe cases had afterwards become more numerous. He had, however, not suffered severe losses, and 8 months later the large reacting division by no means made a bad impression. Finally, it is to be noticed that tuberculin has been employed on a large scale in Denmark for years, and still the demand from farmers constantly increases. This could certainly not be the case if the injections were generally followed by bad results.

Paige said, after the tests of the herd of the Massachusetts Agricultural College, that "its use is not followed by any ill effects of a serious or permanent nature."

Lamson, of the New Hampshire College Agricultural Experiment Station, said: "There is abundant testimony that its use is not in any way injurious to a healthy animal."

Conn, who made a special study of the present attitude of European science toward tuberculosis in cattle, reached the following conclusions:

It has been, from the first, thought by some that the use of tuberculin produces a direct injury upon the inoculated animals. This, however, is undoubtedly a mistake, and there is no longer any belief anywhere on the part of scientists that the injury thus produced is worthy of note. In the first place, the idea that it may produce the disease in a perfectly healthy animal by the inoculation is absolutely fallacious. The tuberculin does not contain the tubercle bacillus, and it is absolutely certain that it is impossible to produce a case of tuberculosis in an animal unless the tubercle bacilli are present. The use of tuberculin, therefore, certainly can never produce the disease in the inoculated animal.

It has been more widely believed, however, that the inoculation of an animal with this material has a tendency to stimulate an incipient case of tuberculosis. It has been thought that an animal with a very slight case of the disease may, after inoculation, show a very rapid extension of this disease and be speedily brought to a condition where it is beyond any use. The reasons given for this have been the apparent activity of the tuberculosis infection in animals that have been slaughtered shortly after inoculation. This has been claimed, not only by agriculturists who have not understood the subject well, but also by veterinarians and bacteriologists. But here, too, we must recognize that the claim has been disproved, and that there is now a practical unanimity of opinion on the part of all who are best calculated to judge that such an injurious effect does not occur. Even those who have been most pronounced in the claim that there is injury thus resulting from tuberculin have, little by little, modified their claim, until at the present time they say either that the injury which they formerly claimed does not occur or that the stimulus of the disease is so slight that it should be absolutely neglected in view of the great value which may arise from the use of tuberculin. Apart from two or three who hold this very moderate opinion, all bacteriologists and veterinarians unite in agreeing that there is no evidence for believing that any injury results. In Denmark, especially, many hundreds of thousands of animals have been inoculated, and the veterinarians say there is absolutely no reason in all their experience for believing that the tuberculin inoculation is followed by any injurious results.

In 1898 tuberculosis was found in the large Shorthorn herd belonging to W. C. Edwards, of Canada, who with commendable promptness and public spirit had his animals tested, and at once proceeded to separate the diseased from the healthy animals. They were all finely bred animals, and of the very class which we have been told are most susceptible to the injurious effects of tuberculin. After using this test regularly for two years, Mr. Edwards wrote as follows:

I have seen nothing to lead me to believe that the tuberculin test had any injurious influence on the course of the disease. It is by no means our opinion that the disease has been stimulated or aggravated by the application of the tuberculin test. All animals that we have tested two or three times continue as hale and hearty as they were previously, and not one animal in our herds has broken down or failed in any way since we began testing.

Mr. Edwards, in December, 1901, verbally stated that his views as to the harmlessness of tuberculin remained unchanged, and that he had not seen the least ill effect in any of his cattle from its use.

Those who have had most experience with tuberculin have failed to observe any injurious effects following its use upon healthy cattle. With tuberculous cattle it produces a fever of short duration, and in the great majority of cases all derangement of the system which it causes disappears within 48 hours after the tuberculin is administered. There appear to have been a very few cases in which the disease was aggravated, and a greater number in which it was benefited by the injection of tuberculin. The cases of abortion following the tuberculin test have not been numerous, even when cows were tested within a few weeks of the normal time of calving. The few cases of this kind which have occurred may be explained by the fact that abortion in cattle is a very common occurrence, and that it would inevitably happen sometimes after the tuberculin test as a mere coincidence and without any relation between the test and the loss of the calf. The cases of abortion which have been cited appear to be no more numerous than might be expected to have occurred among the same number of cattle within the same period if the test had not been applied.

At the present time there is ample evidence to show that tuberculin is the most reliable means of detecting tuberculosis in the living animal and that its use is not attended by any harmful aftereffects.

An act of Congress was approved July 24, 1919, for the purpose of controlling and eradicating tuberculosis of animals. The official means of detecting tuberculosis in the living animal is the tuberculin test, which may be applied by three different methods--the subcutaneous, the intradermic, and the ophthalmic. It is not necessary to discuss here the details of these three methods, which are made use of in the work of eradication of tuberculosis.

The plan adopted by the State and Federal authorities in eradication of the disease is known as "The Accredited-Herd Plan." Under this plan herds are tested under State and Federal supervision, the diseased animals are appraised, removed, and slaughtered under Federal inspection. Retests are then made after definite periods of time until two successive tests show all the animals to be free from the disease. At this time the herd owner is given a certificate of an accredited herd.

Details concerning the accredited-herd plan may be obtained by applying to the Chief of the Bureau of Animal Industry, Washington, D. C.

THE TUBERCULIN TESTS.

Testing animals with tuberculin is the process of introducing tuberculin into the animal and interpreting results according to well-known standards.

From the investigations and observations that have been mentioned, it may be safely concluded--

1. That the tuberculin test is a wonderfully accurate method of determining whether an animal is affected with tuberculosis.

2. That by its use the animals diseased with tuberculosis may be detected and removed from the herd, thereby eradicating the disease.

3. That it has no injurious effect upon healthy cattle.

4. That the comparatively small number of cattle which have aborted, suffered in health, or fallen off in condition after the test were either diseased before it was made or were affected by some cause other than the tuberculin.

THE SUBCUTANEOUS TEST (UNDER THE SKIN).

The most frequently used method of testing is the subcutaneous test, which consists in injecting the proper quantity of tuberculin underneath the skin into the subcutaneous tissue. If an animal is tuberculous, the action of the tuberculin causes a fever, which is indicated by a rise in temperature. This rise, under ordinary conditions, may occur any time between the eighth and twentieth hours after the tuberculin is injected, but in some cases it is desirable to measure the temperature before the eighth hour and continue to the twenty-fourth hour or longer.

The temperatures are measured at least 3 times in advance of the injection, at 2-hour intervals, to learn whether the animal is in proper condition to receive the test. The temperatures after injection are taken every 2 hours until the test is completed. The proper interpretation of the temperatures is made by the person applying the test, and a careful observance of any clinical changes is always important in determining the result. It can not be set forth too strongly that the test, including the two following methods, should be attempted only by those who are properly qualified to do the work.

THE INTRADERMIC TEST (INTO THE SKIN).

The intradermic test for detecting tuberculosis is used to a considerable extent, especially in area work and on range cattle not easily controlled. When made by those who have become skilled in its application, it is very accurate. In this test the tuberculin is injected between the layers of the skin, only a few drops being used, and it is usually applied in the region at the base of the tail, where the skin is soft and nearly hairless. The intradermic test is satisfactory also for the diagnosis of tuberculosis in swine and, when so used, the tuberculin is applied into the skin of the ear near its base.

The reaction from the intradermic test consists of a swelling at the point of injection and is observed from 72 to 150 hours after the injection. The character of the swelling varies, and a proper diagnosis of tuberculosis by this test can be made only by an experienced person.

THE OPHTHALMIC TEST (INTO THE EYE).

Still another method, known as the ophthalmic test, is used quite frequently and has been found to be of considerable value in what is known as "check" testing; that is, it is used in connection with either of the previously described methods. Sometimes a tuberculous animal that fails to react to those tests shows evidence of the disease upon the application of the ophthalmic test. The ophthalmic tuberculin is placed in one eye and the other eye is used as a check. A reaction is indicated by a characteristic discharge from the eye receiving the treatment, which may occur in from 3 to 10 hours after the application or even later. Some swelling and inflammation of the eye and lids are often noted.

TREATMENT OF TUBERCULOSIS.

Treatment of the disease is not seriously considered by any authorities at the present time.

The measures to be adopted to prevent the spreading of the disease must take into consideration not only the tubercle bacillus, but likewise all those circumstances that make cattle more susceptible to the disease, and which have already been dwelt upon. It would be useless to repeat here all that has been said above on the transmission of tubercle bacilli from one animal to another, and on the dangers of certain debilitating influences. A careful study of these influences will show how tuberculosis may, at least in some cases, be prevented. Great care should be bestowed upon the breeding, the surroundings, and the feed of the animal, so that the latter may be put into a condition to resist infection even when exposed to it. A tuberculin test should be applied to all strange cattle before they are introduced into the herd, and those which show a reaction should be refused.

A rigid exclusion of tuberculous animals is all that is necessary to prevent the appearance of the disease, provided cattle are not infected by consumptive persons and animals. The transmission of the disease from man to cattle is probably not frequent, but is regarded as a possible source of infection.

Tuberculosis in cattle must also be considered as bearing upon tuberculosis of other domesticated animals, particularly hogs. In Europe and the United States this disease is not uncommon among hogs, and appears to be on the increase. The reason for its existence may be looked for in the feeding of pigs with skim milk, buttermilk, and whey from creameries, with the offal of the abattoirs, with the household refuse generally, and behind tuberculous cattle. If tuberculosis is common among cattle, it is likely to be transmitted to hogs kept in this way.

The carcasses of animals which have died of tuberculosis should be buried deeply so that they can not be eaten by other animals. This is likewise true of all organs or tissues of slaughtered animals containing tubercles. These should never be fed to other animals, such as hogs, dogs, and cats, and should either be destroyed by fire or deeply buried.

When any of the animals in a herd of cattle show evident symptoms of tuberculosis, or when the tuberculin test proves that they are affected with this disease, the best method of procedure in most cases is to have the affected animals slaughtered and the stables disinfected. A large proportion of the animals which are slightly affected yield carcasses which are perfectly wholesome and fit for human food, but in all such cases there should be an inspection by an expert at the time of slaughter to determine which carcasses may be used and which should be destroyed.

The disinfection of stables may be accomplished by thoroughly cleaning them, scrubbing the floors with hot water, brushing down all loose dust from the walls, and tearing off all woodwork which is partly decayed. Then the whole interior of the stable should be covered with a good coat of limewash containing 1 part of formalin (which is a 40 per cent watery solution of formaldehyde) to 30 parts of the lime wash, or 4 ounces of formalin to each gallon of lime wash.

Similar precautions should be observed in removing the manure of the infected herd from the barnyard and other places accessible to cattle, since it is known that tuberculous cattle frequently eliminate large numbers of tubercle bacilli through the feces. The ground under the manure pile should then be disinfected, either by the above-mentioned formalin solution or by unslaked lime thickly sprinkled over the soil.

If all the animals which react are destroyed and the stables disinfected in this manner, the herd should remain free from the disease unless other affected animals are added to it. The introduction of the disease in this manner may be avoided by requiring a tuberculin test of all new animals admitted on the premises.

Unfortunately it is a fact that tuberculous animals which have been tested several times may become so accustomed to tuberculin that they will no longer react; consequently it is always advisable to purchase cattle from some one who is known to be reliable, as otherwise animals of this kind may be treated with tuberculin for the purpose of hiding the disease.

In the case of very valuable purebred animals and under exceptional circumstances it may be more advantageous to retain the reacting animals which are in good condition in order to breed from them and in that manner avoid the excessive loss which would follow from their immediate slaughter. This may be done if proper precautions are adopted.

The disposal of reactors depends upon the State laws and live-stock regulations of the State in which the herd belongs. If this policy is followed it should be attempted only after careful study of the plan known as the Bang method of controlling tuberculosis. The live-stock officials of the State should be frequently consulted and their advice followed; otherwise failure will surely ensue. The plan necessitates considerable trouble and is not recommended except under the circumstances mentioned.

BOVINE TUBERCULOSIS AND THE PUBLIC HEALTH.

The increasing amount of evidence pointing to the identity of human and animal tuberculosis, combined with the extraordinary mortality of human beings from this disease, often amounting to 10 to 14 per cent, has raised the question in all civilized countries as to how far animal, and especially bovine, tuberculosis is to blame for this high mortality. The medical and veterinary professions have approached this problem with equal zeal, and much has come to light within recent years which enables us to come to some conclusion. If this disease is transmitted from animals to man, how does the transmission take place? As comparatively few people come in direct contact with tuberculous cattle, it must be either through the meat, the milk, the butter, the cheese, or through all these products that the virus enters the human body. The question has thus narrowed itself down to the food products furnished by cattle.