66 THE TUBERCULIN THERAPY. 



In addition, there was normal vesicular breathing, no temperature, no catarrh, and a 

 good general condition. Undoubtedly it is difficult to say whether this case is cured. 

 Only years of observation can prove this. A temporary latency of symptoms must 

 always be considered. Suffice it to say, that the patient was a great deal improved 

 and able to return to her work. 



On close observation of this chart it will be noticed that practically no 

 reactions occurred in spite of the rather rapid increase in the dosage. Slightly 

 increased temperatures were manifest only occasionally (o.ooooi c.c. S. 

 B. E.). Even though the same dose was not repeated on account of the 

 long intervals between the individual injections, no increased reaction 

 appeared after subsequent inoculation. When o.i c.c. of S. B. E. produced 

 no reaction, the susceptibility to B. E. was tested. Doses of o.oooi B. E. to 

 0.5 B. E. were administered at short intervals, without any symptoms. 

 Only after i.o c.c. of B. E., was there a slight increase of temperature with 

 rather marked general manifestations (headache, pains in the extremities, 

 weakness etc.) which subsided within twenty-four hours. On repetition of 

 the same dose, no reaction occurred. 



Six days later, when for the third time i c.c. of B. E. was given there 

 appeared a very marked disturbance throughout the system, an evidence of 

 hyper-susceptibility. (See Chart 2). 



3. Bo vine -tuberculin. 



Koch's differentiation between bovine and human tuberculosis led to the 

 attempt at immunization of cattle with human tubercle bacilli. (Bovo- 

 vaccine of Behring, and Tauruman of Koch). 



Spengler tried to reverse this use and employ the milder, infectious 

 bovine bacilli for the tuberculin therapy in man. He used these bacteria to 

 make up preparations similar to the old and new tuberculin. In this connec- 

 tion he had recourse especially to the P. T. O. (Perlsucht Original Tuber- 

 culin) i.e., the preparation analogous to T. O. A. 



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

 reactions are supposed to be of a nature less severe, 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 inocu- 

 lation material 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 r61e in the 

 question of tuberculosis immunity. These men prepared a wax-like substance, nastin, 

 from a streptothrix 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. 



