TUBERCULOSIS. 235 



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. 



Probably the most interesting use to which the TR- 

 tuberculin has thus far been put is found in the experi- 

 ments of Fisch, 1 w r ho immunized a horse with it, hoping 

 to produce an antitoxin that might be useful in treating 

 tuberculosis. His experiment seems to have met with 

 remarkable success, for the serum thus secured, which 

 he calls "Antiphthisic Serum, TR," is found to thor- 

 oughly immunize guinea-pigs to tuberculosis, to cure 

 tuberculous guinea-pigs in the early stages of the dis- 

 ease, and to neutralize the effects of tuberculin upon 

 tuberculous animals. 



Upon human beings it is too early to make a positive 



1 Jour, of the Amer. Med. Assoc., Oct. 30, 1897. 



