842 



THE POPULAR SCIENCE MONTHLY. 



It can not yet be said that the exact 

 status of Koch's remedy is fixed ; nor can 

 we even yet say with certainty that this 

 much-heralded cure is destined to sur- 

 vive among established methods at all. 

 The most that is claimed for it by its 

 most ardent advocates is that it seems 

 capable of depriving the bacillus of the 

 material in which it thrives best i. e., 

 of disintegrating and destroying tuber- 

 culous tissue. There has been no claim 

 that it has any direct effect upon the 

 existence of the bacillus, nor that it, 

 having deprived the bacillus of its food, 

 tends in any way to remove that para- 

 site from the body, and thus to elimi- 

 nate the possible source of danger of 

 subsequent or more general infection. 

 Under its influence in some forms of 

 local tuberculosis especially of the 

 6kin it has been shown that tissue 

 which was of the very lowly organized 

 variety characteristic of the disease has 

 been at first in part and then wholly 

 replaced by a tissue of higher organiza- 

 tion, and one that is likely to be per- 

 manent. 



In regard to tuberculosis of the 

 lungs, there can be no question that im- 

 provement in the patient's general con- 

 dition and also evidence of improve- 

 ment at the site of the disease have 

 followed the use of this remedy. The 

 general improvement manifests itself 

 by a gain in weight, lessening of fever, 

 increased appetite, better sleep. The 

 local improvement is surmised from cer- 

 tain changes to be observed by auscul- 

 tation and percussion, together with a 

 diminution in the severity of the cough 

 and in the amount of the expectoration, 

 and also a diminution in the number of 

 the bacilli in the expectoration or their 

 complete disappearance from it. This 

 has not always been the case. In not 

 a few instances no improvement has 

 resulted, and in other cases direct and 

 most damaging results, including haem- 

 orrhage and even death, have been 

 brought about by it. In the treatment 

 of tuberculosis of the bones and joints 



results seem to have been widely differ- 

 ent. It is certain that some cases have 

 been benefited, and equally certain that 

 others have not. 



Quite startling testimony to the pos- 

 sible causation of bad effects in a mis- 

 cellaneous group of cases has recently 

 been adduced in Berlin. This testimony 

 is in the shape of the results of twenty- 

 one autopsies made by Prof. Virchow 

 of the bodies of patients who had been 

 treated by Koch's fluid. Of these 

 twenty-one cases sixteen were cases of 

 consumption in the ordinary sense 

 that is, cases in which the disease was 

 either wholly or chiefly in the lungs. 

 The others included bone disease, 

 chronic pleurisy, and tubercular menin- 

 gitis. Some of the diseased changes 

 described in important tissues and or- 

 gans in the lungs, heart, brain, intes- 

 tines, and elsewhere, which can be di- 

 rectly ascribed to the influence of the 

 " lymph " make one feel that the rem- 

 edy is quite as potent for evil as it is for 

 good. Some of these effects were very 

 disastrous in their results, even though 

 the cases had, as a rule, been carefully 

 selected by competent physicians as be- 

 ing appropriate subjects for the new 

 treatment. Virchow shows how the 

 process of consumption in the lungs can 

 be made to spread and involve greater 

 areas by the gradual loosening of masses 

 of tubercular tissue from their original 

 sites and their transference elsewhere. 

 He shows how the disease in the larynx 

 can be caused to take a sudden and very 

 serious turn in consequence of the local 

 swelling produced by the treatment. 

 This may be so great as to prevent the 

 entrance of air to the lungs, and cause 

 death at once by suffocation. He shows 

 how a fresh eruption of tubercles may 

 be caused by it, and demonstrates their 

 presence in the coverings of the brain 

 and of the heart and elsewhere. He 

 explains these occurrences by the hy- 

 pothesis that the new remedy is capablo 

 of disturbing a localized tubercular focus 

 and setting free the virus of the diseaso 



