Probably the most popular objection to tuberculin is that it is too searching, since it discovers cases in which the lesions are small and obscure. While this fact is admitted, it should also be remembered that such a small lesion to-day may break down and become widely disseminated in a relatively short period. Therefore any cow affected with tuberculosis, even to a slight degree, must be considered as dangerous not only to the other animals in the herd but also to the consumer of her products.
In 1898 Bang, of Copenhagen, one of the highest European authorities, in his paper presented to the Congress for the Study of Human and Animal Tuberculosis, at Paris, said:
Numerous tests made in almost every civilized country have demonstrated that in the majority of cases tuberculin is an excellent means for diagnosing the existence or nonexistence of the disease, but giving us no positive information as to the extent to which the disease has progressed. When tuberculin produces a typical reaction we may be almost sure that there exists in the body of the animal a tubercular process. The cases in which a careful examiner has not succeeded in finding it are very rare, and I am led to believe that when, notwithstanding all the pains taken, it has escaped discovery, the reason is that it is located in a portion of the body that is particularly inaccessible. Nevertheless, it is not to be denied that a fever, entirely accidental and of short duration, may in some rare cases have simulated a reaction. However this may be, the error committed in wrongly condemning an occasional animal for tuberculosis is of no practical consequence.
A worse aspect of the case is that there are some diseased animals in which tuberculin fails to discover the existence of tuberculosis. In most of these, no doubt, the deposits are old, insignificant, and generally calcified, or they are cases where the disease is arrested and perhaps in process of recovery, and which are possibly incapable of disseminating the contagion. But it is known that there are cases, not altogether rare, where tuberculin fails to cause a reaction in a highly tuberculous animal, and consequently one in which the disease exists in an extremely contagious form. For this reason a clinical examination should always be made of an animal which does not give a reaction but which shows symptoms indicating that, notwithstanding the test, it may suffer from tuberculosis.
Nocard, of Paris, wrote also in 1898 as follows:
The degree of certainty of the indications furnished may be stated in precise terms. The observation of a clear reaction to tuberculin is unequivocal; the animal is tuberculous. The pretended errors imputed to the method are explained by the extreme sensitiveness of the reagent, which is capable of detecting the smallest lesion. It often requires prolonged and minute researches in the depths of all the tissues to discover the few miliary centers, the presence of which has been revealed. The reaction is absolutely specific. In those cases where it is observed with animals which show lesions of another disease (actinomycosis, hydatid disease, verminous bronchitis, distomatosis), it may be affirmed that there exists, in addition to these conspicuous changes, a tuberculous center which alone has provoked the reaction.
The failure to react does not necessarily imply absence of tuberculosis. Such failures of tuberculin are very exceptional. They are seen most frequently with animals affected with tuberculosis in a very advanced stage and made evident by plain external signs. Sometimes, also, there are found at the post-mortem examination of animals which have not reacted small fibrous or calcified lesions in such a condition that one is tempted to believe them cured. Whether sterile or not, these lesions have no tendency to increase, and they are not very dangerous from the point of view of contagion.
These opinions of two eminent authorities, living in different countries, after long experience of their own and after studying the results of the many tests made in different parts of the world, should have great weight. They are essentially the same throughout.
In 1897 Voges compiled statistics of tuberculin tests, the accuracy of which had been determined by post-mortem examination. Of 7,327 animals tested, it appeared that errors had been made with 204, or 2.78 per cent. In the work of the Pennsylvania Live Stock Sanitary Board post-mortem examinations were made on about 4,400 reacting cattle and the disease was found in all but 8 of those which had given characteristic reactions.