722 ACTIVE IMMUNIZATION 



Barbour. 1 These observers used this method quite extensively with 

 lower animals, and have also secured good results with persons willing 

 and anxious to take all possible risks for the possible good that may 

 result. In no case have harmful results followed the injections. 



More recently the profession and laity have been agitated by the 

 extravagant claims of Friedmann for a vaccine of living, acid-fast 

 bacilli derived from the turtle. This culture is said to be avirulent for 

 human beings, and to be capable of stimulating specific antibodies and 

 thus bringing about a cure. The unfortunate methods by which these 

 claims have been exploited, and the more recent investigations, tending 

 to show that no good has followed its use, and that the vaccine is not 

 entirely harmless, preclude any statements at this time. The principle 

 involved, however, namely, the use of a living vaccine composed of 

 microorganisms so altered by passage through a lower animal that they 

 cannot produce tuberculosis in the human being, but yet resembling the 

 human bacillus closely enough to 'produce specific antibodies, is sound, 

 and should stimulate further experimental research in this direction. 



Patients Suitable for Tuberculin Treatment. In deciding which 

 tuberculous patients are best suited to receive tuberculin treatment it 

 must be borne in mind that tuberculin is not a form of passive immunity, 

 depending upon antitoxins, bacteriotropins, and bactericidins, but that 

 it serves to stimulate the body-cells to produce these protective sub- 

 stances. The output of antibodies provoked by tuberculin is dependent 

 upon the condition of the body as a whole, and its administration can 

 be of no help if the resources of the body are exhausted and the cells are 

 incapable of beneficiary reaction. In other words, tuberculin therapy 

 must be guided by the same considerations that influence the vaccine 

 treatment of acute infections in general. 



1. Patients afflicted with incipient tuberculosis are proper subjects 

 for receiving tuberculin treatment, since it tends to protect them from 

 relapse, and insures, to a greater degree, their ability to continue work. 



2. Advanced and moderately advanced cases may be given tuberculin 

 if the nutrition is fair, the febrile reaction mild, the pulse not very rapid, 

 and if the treatment is controlled by rest. Old fibroid cases with fair 

 nutrition are especially suitable, as such patients become capable of 

 moderate activity and are much less likely to suffer from relapses. 



3. Cases of tuberculosis of the lymphatic glands, skin, and special 

 organs may be benefited by prolonged and careful tuberculin therapy. 



4. Cases of latent tuberculosis, especially the children of infected 



1 The Kansas Univ. Sci. Bull., 1907, iv, No. 1. 



