[Present findings on the determination of mycobacterial resistance]

The change of the signification of the appearance of tuberculosis is explained (1) in a cognition-theoretical, (2) under a more medical practical aspect and (3) in the real prevalence of tuberculosis in autopsies nowadays. The pathology of the tuberculosis and of its different manifestations were known in the main before the detection of tubercle bacteria by Robert Koch. However, its nature and its cause and the connexions of the different forms of tuberculosis were wrongly interpreted in relations to the timely knowledge. Not till the detection of the tubercle bacteria and confirmation of tuberculosis as a bacterial infectious disease the pathology gained new possibilities to take part in further investigations in the disease with great success. The disease of tuberculosis goes back to earliest time of mankind. Since this time it existed until the middle of 20th century in nearly the same manner, not curable with a high morbidity and mortality and heavy courses. A change of its course to lower mortality and a decrease of the heavy exudative forms could be observed after getting a higher social standard of life in many countries, by the modern prophylaxis and therapy of the tuberculosis and related to a disease drifting into the older ages of men with a predominance of milder forms of tuberculosis in this age. We use our observations of 53,167 autopsies of adults with a total number of 2277 (4.3%) tuberculosis, (1249 = 2.4% inactive and 1028 = 1.9% active tuberculoses) to explain some facts about the present situation of tuberculosis. In this time the relative amount of tuberculosis among the whole number of autopsies decreased from 6.4% to 3.2%, the active tuberculosis from 3.8% to 0.8%. In 1961 we still found 39% exudative-cavernous tuberculosis of lungs, 1981 only 21%. But the amount of tuberculosis miliaryis pulmonum increased in this period from 3% to 26%, the generalised tuberculosis miliaris from 17% to 53%. 1981 only 1 tuberculosis deceased was younger than 50 years. But alarming is the fact that more than 50% of active tuberculosis and 63% of the miliar tuberculosis in the last 10 years were not diagnosed in lifetime but only by autopsy.