282 PUBLIC HEALTH BACTERIOLOGY 



Chamberland filters and not heated, but 0-25 per cent 

 phenol added to preserve. Corresponds to " old 

 tuberculin," unconcentrated and unheated, and therefore 

 supposed by Denys to contain important soluble but 

 thermolabile substances. 



Therapeutic uses of the Tuberculins. (So-called 

 Vaccine Therapy.) For these purposes, tuberculin-R and 

 bacillary emulsion are mostly used in doses beginning at 

 o-ooi mgr. ( T7 jV7j)> and gradually increased so long as the 

 dose causes no greater disturbance of temperature than 

 0-5 F. In Wright's method of treatment the initial dose 

 is usually T ^^ mgr., and is rarely increased beyond y^Vir 

 mgr. The dose is administered after determination 

 of the opsonic index of the patient, and subsequent doses 

 are only administered during the positive phase of the 

 reaction to the previous dose. To determine this, 

 repeated observations of the opsonic index have to be 

 made. As a result of experience gained by a large number 

 of observations, some authorities advise the use of smaller 

 doses, g^iy^ mgr. every ten days, gradually increased to 

 4T nnr mgr. in six months' time, without opsonic index 

 estimation, but simply watching the clinical symptoms. 



In the serum of patients so treated there is evidence of 

 the formation of bodies antagonistic to tuberculin, of the 

 nature of immune-bodies, precipitins, and opsonins. 



Antituberculous Sera. Maragliano's Serum. Made 

 by him by immunizing dogs, asses, and horses, by injecting 

 a mixture of the nitrate of an unheated broth culture 

 (i part) and an aqueous bacillary extract at 100 C. (3 

 parts). The animal is bled after four to six months. 

 Of the serum, 2 c.c. are injected subcutaneously every two 

 days. Improvement has been noted in non-febrile cases. 

 The serum is capable of protecting an otherwise healthy 

 animal against a fatal dose of tuberculin. 



Marmorek's Serum. Marmorek believes the tubercle 

 bacillus does not produce in ordinary media the same 

 toxins that it does in the body, where it has to resist the 

 antagonism of the body cells. To combat this he first 

 grows the bacilli on a leucotoxic serum (produced by 

 inoculating calves with guinea-pig leucocytes), and then 

 on a medium containing liver extract, the liver being 



