VACCINE TREATMENT OF TUBERCULOSIS 205 



four to twelve or fourteen hours (according to the size of the dose), 

 and then subsides so that normal relations are restored within 

 twenty-four or thirty-six hours, the patient merely experiencing a 

 certain degree of lassitude and tendency to increased expectoration, 

 which may continue for several days. The height of the temperature 

 dift'ers considerably, and while usually not exceeding 102 F., it may 

 reach 103 and 104. 



In especially susceptible people, or when the higher doses are 

 reached, the systemic symptoms may be much more severe and 

 extend over many days, and during such a period it would, of course, 

 be a mistake to repeat the injection. When these febrile periods 

 are very lengthy and accompanied by lasting loss of weight and 

 cardiac disturbance of notable degree, the treatment should be 

 suspended or eliminated. 



Results. So far as the results of the tuberculin treatment go, so 

 much depends upon the individual case, the duration of the disease, 

 the character and seat of the lesion, the possibility of supplementing 

 vaccination with adequate hygienic treatment, etc., that from a 

 prognostic standpoint every case must be judged upon its own merits. 

 Suffice it to say that the average case, cceteris paribus, does better 

 under immunization treatment than without it, and that every 

 physician should recognize the rationale and value of the method. 

 But I feel very strongly that in order to obtain the best results the 

 treatment should be carried out either in special institutions or by 

 men who are thoroughly familiar with the intricacies of immunization 

 methods. As a matter of fact the best results have been reported 

 from just such sources. 



Bandelier thus found that of 202 cases of pulmonary tuberculosis 

 which had been treated with tuberculin, 63 per cent, no longer had 

 tubercle bacilli in their expectoration. The best results, as would 

 be expected, were obtained during the first stage of the disease where 

 100 per cent, of the cases became bacilli-free; among those in the 

 second stage this point was reached in 87 per cent., and among those 

 in the third stage in 44.2 per cent. As Bandelier states, an equally 

 favorable series has not been recorded in the literature. The patients 

 in question had been treated in sanatoria belonging to the Landes- 

 Invalidenversicherung, of Berlin. Koch's old tuberculin had been 

 used in all cases where the physical examination suggested a tendency 

 to fibrous changes, or in which, in spite of extensive infiltration, there 



