TUBERCULOSIS. 3 2 5 



whose treatment must not be begun too late. ... A 

 patient who has but a few months to live cannot ex- 

 pect any value fronj the use of the remedy, and it will 

 be of little value to treat patients who suffer chiefly from 

 secondary infection, especially with the streptococcus, 

 and in whom the septic process has put the tuberculosis 

 entirely in the background." 



By proper administration of the TR Koch was able to 

 render guinea-pigs so completely immune that they were 

 able to withstand inoculations of virulent bacilli. The 

 point of inoculation presents no changes when the 

 remedy is administered, and the neighboring lymph- 

 glands are generally normal, or when slightly swollen 

 contain no bacilli. 



One very important objection found by Trudeau and 

 Baldwin against commercially prepared TR is that it is 

 possible for it to contain unpulverized, and hence live, 

 virulent tubercle bacilli. In the preparation of the rem- 

 edy it will be remembered that no antiseptic or germicide 

 was added to the solutions, by which the effects of acci- 

 dental failure to crush every bacillus could be overcome, 

 Koch having specially deprecated such additions as pro- 

 ducing destructive changes in the TR. Until this objec- 

 tion can be removed, and our confidence that our attempts 

 to cure patients will not cause their death be restored, it 

 becomes a question whether TR can find a place in 

 human medicine at all, or must remain an interesting 

 scientific laboratory demonstration. 



Baumgarten and Walz ' find that the administration of 

 tuberculin-R to guinea-pigs is without curative effect. 

 They emphasize that the results obtained are like those 

 of the old tuberculin; that "small doses are of no ad- 

 vantage, while the larger the doses one employs, the 

 greater are the disadvantages that result from their em- 

 ployment." 



Probably the most interesting use to which the tuber- 

 culin-R has thus far been put is found in the experi- 



1 Centralbl.f. Bakt. und Parasitenk., April 12, 1898, xxiii., No. 14, p. 593. 



