72 TUBERCULIN THERAPY 



bacteria to make up preparations similar to the old and new tuberculin. 

 He favored especially the P. T. O. (Perlsucht Original Tuberculin) i.e., 

 the preparation analogous to T. 0. A. 



Bovine tuberculin is said to be borne better than the human. The 

 reactions are supposed to be of a less severe nature, and the therapeutic 

 results just as good or even better. 



4. Nastin. 



All the above-mentioned preparations have as their aim the production of an agent 

 which is to contain the substances embodied within the tubercle bacilli, and which 

 are more or less correctly considered as representing their poisonous elements. 

 Deycke and Reschad showed that the fat-like material encapsulating the bacteria, 

 to which is ascribed their strongly acid fast character, also plays an important 

 role in the question of tuberculosis immunity. These men prepared a wax-like sub- 

 stance, nastin, from a strep tothrix which they found as a saprophyte in a case of 

 leprosy streptothrix leproides. Nastin closely resembles the fat-like substance of the 

 tubercle bacilli and with it one can immunize healthy guinea-pigs against living virulent 

 tubercle bacilli. In the treatment of tuberculosis, however, it has no beneficial effect. 

 On the day after inoculation, fever sets in, sputum increases in great quantities and 

 contains large amounts of tubercle bacilli. In leprosy, slight improvement has been 

 noticed by its use. 



Metalnikoff has confirmed the above findings and further shown that the bee moth. 

 Galena Molinella, attributes its very high immunity against tuberculosis to a strong 

 wax dissolving ferment possessed by it. It is probable, too, that inoculations of nastin 

 produce antibodies which have the power of dissolving fat. In this way the capsule 

 of the tubercle bacillus is destroyed and the antigen is liberated to be absorbed. 

 While healthy animals can thus be immunized, tuberculous individuals would be indi- 

 rectly receiving a tuberculin injection, and its amount would depend upon the quantity 

 of tubercle substance suddenly liberated. It seems to the author that the more 

 rational way of conducting this therapy would be, to first obtain a high immunity 

 against the substance of the tubercle bacillus by injection with B. E., and then to follow 

 this by treatment with nastin. Such treatment may prove an interesting new step in 

 tuberculin therapy. 



Tebesapin. 



Noguchi and Zeuner found that if tubercle bacilli are exposed to the action of 

 soaps of unsaturated fatty acids, their capsule is penetrated and the bacteria are 

 destroyed; in this form their injection into animals will produce no infection or only a 

 mild slowly progressive one. Guinea-pigs which remain healthy after receiving such 

 saponified dead organisms, can after three months withstand infection by virulent 

 tubercle bacilli. At Zeuner's recommendation a preparation known as Tebesapin has 

 been put on the market by Schering-Berlin. It is made up in the following manner: 

 Tubercle bacilli are shaken for four days at a temperature of 37 C. with an emulsion of 

 sodium oleate i : 60 in distilled water; the mixture is then heated for one hour at 70-72 

 C. and again shaken at 37 C. for three days; then centrifugalized and filtered. It is 

 preserved by the addition of 0.4 per cent, trikresol. Various dilutions of the prepara- 

 tion can be obtained. v - 



