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Updated: June 18, 2025
Within about a decade of the close of the century, Robert Koch, whose discoveries and ingenious studies in bacteriology had brought him world-wide renown, announced that he had produced a derivative of the tubercle bacillus, which he termed tuberculin, that he thought might prove curative of tuberculous disease. It was to be injected beneath the skin.
He was still reading in chambers, however, when his first cousin, the Duke, a melancholy semi-invalid, a widower, with an only son tuberculous almost from his birth, arrived from abroad. Jacob was brought into new contact with him. The Duke liked him, and offered him the agency of his Essex property.
The mixed infection is chiefly responsible for the pyrexia, sweating, and emaciation which the laity associate with consumptive disease. A tuberculous abscess may in one or other of these ways be a cause of death.
In this, he described a fatal disease during which the individual affected became languid and weak, and developed a dingy or smoky discoloration of the whole surface of the body, a browning or bronzing of the skin, caused generally by destructive tuberculous disease of the suprarenal or adrenal bodies.
If the subject was really tuberculous, he would "react" by manifesting a certain degree of fever, and repeated injections would bring about elimination of the tuberculous deposits and thus effect a cure. The world was carried away with such an announcement coming from such a man, and it was thoroughly believed that at last "the great white plague," consumption, was to be conquered.
Amputation for tuberculous joint disease has become one of the rare operations of surgery, and is only justified when less radical measures have failed and the condition of the limb is affecting the general health. Amputation is more frequently called for in persons past middle life who are the subjects of pulmonary tuberculosis. Syphilitic affections of joints are comparatively rare.
#Tuberculous disease in the glands of the groin# is comparatively rare. We have chiefly observed it in the femoral glands as a result of inoculation tubercle on the toes or sole of the foot. The affected glands nearly always break down and suppurate, and after destroying the overlying skin give rise to fungating ulcers. The treatment consists in excising the glands and the affected skin.
The ward seemed pleasant and friendly when he entered it. The sister greeted him with a quick, business-like smile. "You're very late, Mr. Carey." "I was out on the loose last night." "You look it." "Thank you." Laughing, he went to the first of his cases, a boy with tuberculous ulcers, and removed his bandages.
Do not think you are going to lecture to picked young men who are training themselves to be scientific discoverers. They are of fair average capacity, and they are going to be working doctors. These young men are to have some very serious vital facts to deal with. I will mention a few of them. Every other resident adult you meet in these streets is or will be more or less tuberculous.
Operative treatment of deformities resulting from tuberculous joint disease has almost entirely replaced reduction by force; the contracted soft parts are divided, and the bone is resected.
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