200 ACTIVE IMMUNIZATION 



was little secretion; also in bone and glandular tuberculosis and in 

 tubercular fistulse of the anus. Otherwise, i. e., when there was 

 extensive softening, or when febrile reactions would have been 

 undesirable, new tuberculin was employed. The outlined treatment 

 with old followed by new tuberculin was mostly used in advanced 

 cases, and seems to have furnished the best results, as gauged by the 

 disappearance of the bacilli in thirty-eight of sixty-nine cases, i. e., 

 in 55.07 per cent. Considering the advanced character of the 

 lesion in these individuals, this is indeed quite remarkable. 



If we contrast these findings with the results of a purely expectant, 

 sc., hygienic-dietetic plan of treatment, where only 20 per cent, of the 

 cases show loss of bacilli, no further argument in favor of the tuber- 

 culin treatment is required. It should be remembered, moreover, 

 that the actual results were probably still better than is suggested 

 by the above figures, if we consider that the improvement continues 

 for three or four months after the treatment is suspended. They 

 might have been still better, as Bandelier suggests, if the limit of 

 immunization, i. e., the maximal dose of tuberculin had been higher 

 than 10 milligrams, which had been chosen as standard. 



Of late, systematic efforts have been made to improve the hygienic 

 condition of the tubercular poor, and to give these also the benefit 

 of the tuberculin treatment when living in their own homes. As a 

 consequence the outlook for these unfortunates has been materially 

 improved. Friedrich thus records that of 700 cases of early tuber- 

 culosis which were treated in this manner the disease was arrested 

 or the patients much improved in 51 per cent, of the cases. Similar 

 results have beer reported from other sources. 



ESTIMATION OF THE OPSONIC CONTENT OF THE BLOOD 

 (WRIGHT'S METHOD) 



Before concluding this chapter it may not be out of place to give 

 a brief account of the technique which Wright recommended for 

 the purpose of estimating the opsonic index, but which at present 

 has but little more than historical interest, in so far as its bearings on 

 treatment or diagnosis are concerned. The necessary apparatus is 

 pictured in the accompanying illustration (Plate III). It consists 

 of a pipette (a) for collecting corpuscles; (6) a tube to receive the 



