336 Tuberculosis 



reported, with careful details, 22 cases of tuberculosis which 

 he claims have been cured by it. 



Recently there has been a return to the use of tuberculin 

 for the diagnosis of tuberculosis, it being claimed that by the 

 use of minute doses, several times repeated, the charac- 

 teristic reaction and a positive diagnosis can be obtained 

 without danger. 



Klebs* has made strong claims for his own modifications 

 of tuberculin, known as antiphthisin and tuberculocidin. 

 According to the experimental studies of Trudeau and Bald- 

 win, however, antiphthisin is only much diluted tuberculin, 

 and exerts no demonstrable influence upon the tubercle 

 bacillus in -vitro, does not cure tuberculosis in guinea-pigs, and 

 probably inhibits the growth of the tubercle bacillus upon 

 culture media to which it has been added, only by its acid 

 reaction. The preparations are no longer mentioned in the 

 literature except as having failed to cure tuberculosis. 



Tuber culin-R. What appears to be an important 

 modification of tuberculin has been made by Koch,f in 

 the TR or tuberculin-R. 



All attempts to produce immunity against the tubercle 

 bacillus by the injection of attenuated cultures, whether 

 dead or alive, fail because of the invariable occurrence of 

 abscesses following their introduction into the cellular 

 tissue, and of nodular growths in the lungs succeeding their 

 injection into the circulation. It seemed as if the fluids of 

 the body could not effect the solution of the bacteria and the 

 liberation of their essential toxic and immunizing constitu- 

 ents. 



Koch therefore endeavored to bring about artificial con- 

 ditions advantageous to the absorption of the bacilli, and 

 for the purpose tried the solvent action of diluted mineral 

 acids and alkalies. The changes thus brought about facili- 

 tated absorption, but the absorption of bacilli in this chemi- 

 cally altered condition was not followed by immunity, prob- 

 ably because the chemic composition of tubercle toxin (or 

 whatever one may name the poisonous product of the 

 bacillus) was altered by the reagents. 



Tuberculin, with which Koch performed many experi- 

 ments, was found to produce immunity only against tuber- 

 culin, not against bacillary infection. 



*"Die Behandlung der Tuberculose mit Tuberculocidin," 1892. 

 t " Deutsche med. Wochenschrift," 1897, No. 14. 



