TUBERCULOSIS TUBERCULIN THERAPY 661 



Autogenous vaccines may be of value in the treatment of delayed 

 resolution in lobar pneumonia, cultures being secured by puncturing the 

 lungs. Usually several microorganisms are found, and a mixed vaccine 

 may be given. 



Autogenous vaccines may also be of service in the treatment of 

 puerperal sepsis and ulcerative endocarditis, especially after the more 

 acute symptoms have subsided. In the former condition a strepto- 

 coccus may be obtained by blood culture or by intra-uterine cultures; 

 in the latter, the infecting microorganism is obtained only by blood 

 culture. Stock vaccines may be administered, but are not likely to 

 prove of value, as both infections are usually caused by streptococci, 

 pneumococci, or some similar microorganisms showing so much differ- 

 ence in individual properties as to make the use of autogenous vaccines 

 imperative. The initial doses should be small not over 50,000,000 

 cocci; they may be repeated every three to five days, and are gradu- 

 ally increased as the conditions warrant. 



TUBERCULOSIS. TUBERCULIN THERAPY 



Historic. Within the last twenty years the subject of tuberculin 

 therapy has elicited considerable discussion in the diagnosis and treat- 

 ment of tuberculosis. The wide-spread prevalence of the disease, not 

 only in man, but in the lower animals as well, the distressing symptoms, 

 the gloomy prognosis, and the economic importance it possesses, are a 

 few of the factors that have stimulated investigators the world over to 

 zealous and persistent efforts directed toward discovering a means of 

 preventing and curing this great scourge. Owing to the nature of the 

 infection, which covers relatively long periods of time, and the fact that 

 much time is required for the conduct of experimental studies, researches 

 are of necessity prolonged, tedious, and difficult. Within a period of 

 less than six years the cause of syphilis has been discovered and isolated, 

 and valuable diagnostic reactions and a well-nigh specific therapy have 

 been devised. The discovery of an early and specific diagnostic and 

 therapeutic measure for tuberculosis will achieve still greater triumphs 

 in fact, few could be greater or more beneficial. 



Koch was the first to note the curative action of tuberculin, and it 

 may be well to refer here to the original description of his fundamental 

 experiments, 1 which have been the basis as well as the starting-point 

 of the entire study of tuberculins. 



1 Deutsch. med. Wochenschr., 1891, xvii, 101. 



