Chapter XXIX: Section XVII: The Communicable Diseases—part I (3)

It is generally believed that tuberculin injected into tuberculous animals, in doses large enough to produce a marked reaction at the site of disease, may stimulate the process to growth and spread and that certain parenchymatous organs in such bodies undergo degenerative changes. We can give little information concerning the first point because known infected animals have not been sacrificed during the test and we are not informed of the degree of morbid lesion in those dying, since we had no previous knowledge of its existence.

FIG. 58.—EFFECT OF TUBERCULIN ON THE KIDNEY. AN UNUSUALLY SEVERE
REACTION IN THE RENAL TUBULES AND INTERSTITIAL TISSUE FOLLOWING A
TEST DOSE OF TUBERCULIN. SUCH A MARKED CHANGE SUGGESTS THAT IN THIS
CASE PRE-EXISTING RENAL DAMAGE WAS AGGRAVATED. THE ANIMAL WAS
TUBERCULOUS BUT HAD NO LESIONS IN THE KIDNEY.
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An interesting and practically useful observation has, however, been made upon the kidneys of several monkeys dying shortly after tuberculin injection. It consists in a marked cloudy swelling of the renal epithelium and a congestion or even thrombosis of the glomerular capillaries, accompanied sometimes by increase of nuclei in the tuft and by amorphous material in the space of Bowman. Grossly such kidneys are but little changed, albeit the cortical zone may be dull and opaque and swell out slightly on section; very occasionally bloody streaks may separate the cortical and medullary striæ. In a few kidneys there have been suggestions of preëxisting nephritis but usually the findings are confined to those given above. At all events true glomerulonephritis is not often found. Monkeys which have this condition may or may not exhibit a behavior suggesting its existence. Sometimes it will be noted that the animal is dull and eats little, at other times the keeper will report that the cage is seldom wetted and we know of cases in which only an ounce or two of urine has been passed in a day. Two monkeys were distinctly ataxic and incoördinate and one of these had a convulsion. From one a specimen of urine showed albumen but no casts.

These signs of renal affection are not always alone nor are the kidneys necessarily the only part diseased since postmortem records show a variety of accompanying lesions, bronchitis and enteritis, for example. There are, however, several cases dying in a few days after tuberculin injection, both with and without tuberculosis, in which the renal changes were quite prominent; two examples, without tuberculosis, exhibited the damage to the kidneys very well and with no other evident visceral pathology. The relation of cause and effect may not be unequivocal, but these findings suggest that the condition of the kidneys deserves attention when tuberculin is to be injected. My associate, Dr. Corson-White, is firmly convinced that the substance whips up a preëxistent parenchymatous disease and wants to see a urinalysis from every monkey that is in any way abnormal.

THE TUBERCULIN TEST IN OTHER ANIMALS.

Two cases of tuberculosis occurred in White nosed Coatis (_Nasua narica_) so that it was decided to test their neighbors in the next cage. There is reproduced a composite (Y) of the temperature record of three of these animals after receiving 2 mg. of tuberculin under the skin. No tuberculosis was found in them at death, all dying within two years. The similarity to the primate type of temperature curve is striking.

Chart Z shows the course of temperature before and after tuberculin injection in a Bactrian Camel (_Camelus bactrianus_) ♀ which lived for some months and showed no infection at autopsy.

Charts AA and BB show the temperature ranges of respectively a healthy and a tuberculous Bison (_Bison bison_.)

Chart CC is that of a Malayan Sambur Deer (_Cervus equinus_) which died a week after injection, showing fibrocaseous tuberculosis. The failure to make an initial rise is noteworthy, but the fall in temperature may be explained by the severity of the lesions and the approaching death.

Chart DD represents daily and post-injection records of a Virginia Deer (_Cervus virginianus_) which at death was found free of the disease. Chart EE is that of a healthy American Elk (_Cervus canadensis_).

CHART Y. Composite chart of three non-tuberculous coatis.
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CHART Z. BACTRIAN CAMEL (Camelus bactrianus). Non-tuberculous.
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CHART AA. AMERICAN BISON (Bison bison). Non-tuberculous.
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CHART BB. AMERICAN BISON (Bison bison). Tuberculous.
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CHART CC. SAMBUR DEER (Cervus equinus). Tuberculous.
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CHART DD. VIRGINIA DEER (Mazama virginiana). Non-tuberculous.
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CHART EE. AMERICAN ELK (Cervus canadensis). Non-tuberculous.
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