232 TUBERCULOSIS. 



Recent results appear to show that the tuberculin reaction (i.e., 

 fever, and local necrosis round tubercular deposits, following injection of 

 tuberculin) is not yet fully understood, for on the one hand other 

 substances besides products of the tubercle bacillus may give rise to 

 similar effects in tubercular animals, and on the other a similar reaction 

 can take place in other diseases besides tuberculosis where there is 

 locally in the body a deposit of new tissue. Matthes has, for instance, 

 found that albumoses and peptones isolated from the ordinary peptic 

 digestion of various albumins give the same reaction in tubercular 

 guinea-pigs. The injection of milk, lactic acid, ricin all give a similar 

 result. Before the discovery of tuberculin, Gamaleia had found that 

 tubercular animals were very susceptible to the toxines of the vibrio 

 Metchnikovi, and later Metchnikoff found that a similar susceptibility 

 existed towards the toxines of the bacillus of fowl cholera. Buchner 

 found that a group of albuminous bodies which he called proteines, and 

 which he extracted from the bodies of the B. anthracis, B. mallei, and 

 B. prodigiosus, produced the tuberculin reaction, and he considered that 

 the active body in tuberculin was probably of the same nature, and 

 had a similar source. There is, however, no evidence that the sub- 

 stances so derived from different bacteria are identical. While the 

 tuberculin reaction has thus been obtained with other bodies besides 

 tuberculin, a similar reaction has taken place when tuberculin has been 

 injected into persons suffering from diseases other than tubercle, e.g., 

 cancer, sarcoma, syphilis. Further investigations on this subject are 

 thus required. 



The Toxines of the Tubercle Bacillus. Koch's work on 

 tuberculin was the first to show that from tubercle cultures 

 substances could be separated the possession by which of 

 a necrotic action on certain tissues was capable of explaining 

 a great pathological feature of tuberculosis. An impulse 

 was thus given to further inquiries as to the action of 

 toxines of the tubercle bacillus. These inquiries were 

 first directed towards finding out what the substance 

 was to which tuberculin owes its action. Hunter showed 

 that tuberculin consisted chiefly of (i) albumoses, 

 chiefly proto- and deutero-albumose, with small quantities 

 of hetero-albumose and a trace of dysalbumose ; (2) alkal- 

 oidal substances, two of which can be obtained in the form 

 of platinum compounds of their hydrochlorate salts ; (3) 

 extractives, mucin, in'organic salts, etc. Hunter prepared 

 two modifications of tuberculin, one of which contained all 

 that could be precipitated by 70 per cent alcohol, and the 



