PATHOGENIC BACTERIA 1 19 



Bacillen emulsion (B. E.) is similar to tuberculin R, and 

 is a glycerin emulsion of crushed bacteria. Theo. Smith 

 recommends virulent uncrushed bacteria killed by moderate 

 heat. 



Denys' B. F. tuberculin is a nitrate of liquid cultures to 

 which 0.25 per cent, phenol has been added and allowed to 

 stand two weeks. It is prepared in eight dilutions. 



Opsonic Treatment. In recent years the use of tuberculin R 

 has again been brought forward by Wright and others and 

 curative claims made for it. It is used in very small doses, 

 T -J au milligram at intervals of several days, and the effect on 

 the opsonic index carefully watched. 



Use of Tuberculin. In the use of tuberculin severe reactions 

 are to be avoided. The smallest dose possible is commenced 

 with. Trudeau uses for afebrile cases YO^OOO milligram liquid 

 measure Koch's B. E., or Denys' B. F., increasing i decigram 

 every three days until i c.c. can be injected without causing 

 any reaction. This treatment must extend over months. 

 Tuberculin immunity does not last indefinitely. 



Ophthalmic Tuberculin Reaction of Calmette. A modified 

 form of tuberculin is placed on the conjunctiva of an individual 

 suspected of having tuberculosis. In a few hours a congestion, 

 more or less severe, results, and lasts several days. In healthy 

 persons no reaction occurs. The test is claimed to be harmless, 

 though severe reactions have been reported, in tuberculous 

 patients, and even in healthy persons a second application to 

 the same eye may cause an inflammatory reaction. 



Agglutination. Arloing and Courmont have described an 

 agglutination reaction for the tubercle bacillus similar to the 

 Widal reaction of typhoid fever (see page 131). It is very 

 unreliable, however, and but little importance is attached to it. 



Antituberculous Serum. The attempts to produce an 

 effective serum have so far been unsuccessful. Marmorek, 

 by growing the bacillus on a special serum obtained by injecting 

 calves with the leukocytes of guinea-pigs, has secured a toxin 

 which he used to immunize horses, and the serum so obtained 

 has been tried with encouraging results, but its value is still 



