TUBERCULOSIS 55 



culosis it is the surcharge of antibody in the interior of the cells 

 which determines the pathologic moment and the lesion. 



It seems that this intracellular surcharge of antituberculin 

 is not indifferent for the organism even without the inter- 

 vention of tuberculin. In fact although an animal strongly 

 immunized and surcharged with diphtheria or tetanus anti- 

 toxin does not seem to suffer at all, a man or an animal sur- 

 charged with tuberculous antibody becomes rapidly hyper- 

 sensitive to all sorts of external agents such as changes in 

 temperature, fatigue and especially a series of non-specific 

 products such as the antigens of pneumococci, pyocyaneous, 

 Metchnikoff's vibrio, divers sera, creosote, etc. This non- 

 specific hypersensitiveness may be explained by the hypo- 

 thesis that the substance which constitutes the tuberculous 

 antibody in the cell is called upon to play a more important 

 role in the life of this cell than, for example, diphtheria anti- 

 body, and that the cell cannot easily rid itself of the excess 

 of antibody which it has produced. In a word there results 

 a sort of hypertrophy of an intracellular organ and of a 

 function which thus becomes abnormal and harmful for the 

 cell and for the organism. 



An interpretation according to these theories of some of 

 the facts determined experimentally by A. K. Krause 1 may 

 serve to clarify the discussion: 



This investigator found that a subcutaneous injection of 

 living tubercle bacilli into a normal guinea-pig will cause in 

 this animal a local lesion (reaction) which will appear only 

 after a relatively long incubation period. 



However, a guinea-pig treated in this way, will, after the 

 healing of this local lesion or tubercle, always react to a new 

 dose of tubercle bacilli (or tuberculin) in a very different 

 way from the first reaction. 



The second dose, if given subcutaneously, will produce a 

 second tubercle but in a very short time and the lesion will 

 be by comparison, large and severe. However, instead of 

 slowly progressing in size perhaps until the death of the 

 animal, the initial severity will soon subside and the 

 "tubercle" will heal. 



1 Krause, A. K.: Jour. Med. Research, 1916. 



