VACCINE TREATMENT OF TUBERCULOSIS 213 



which had been treated with tuberculin, 63 per cent, no longer had 

 tubercle bacilli in their expectoration. The best results, as would 

 be expected, were obtained during the first stage of the disease where 

 100 per cent, of the cases became bacilli-free; among those in the 

 second stage this point was reached in 87 per cent., and among those 

 in the third stage in 44.2 per cent. As Bandelier states, an equally 

 favorable series has not been recorded in the literature. The patients 

 in question had been treated in sanatoria belonging to the Landes- 

 Invalidenversicherung, of Berlin. Koch's old tuberculin had been 

 used in all cases where the physical examination suggested a tendency 

 to fibrous changes, or in which, in spite of extensive infiltration, there 

 was little secretion; also in bone and glandular tuberculosis and in 

 tubercular fistulse of the anus. Otherwise, i. e., when there was 

 extensive softening, or when febrile reactions would have been 

 undesirable, new tuberculin was employed. The outlined treatment 

 with old followed by new tuberculin was mostly used in advanced 

 cases, and seems to have furnished the best results, as guaged by the 

 disappearance of the bacilli in thirty-eight of sixty-nine cases, i. e., 

 in 55.07 per cent. Considering the advanced character of the 

 lesion in these individuals, this is indeed quite remarkable. 



If we contrast these findings with the results of a purely expectant 

 (sc., hygienic-dietetic) plan of treatment, where only 20 per cent, of the 

 cases show loss of bacilli, no further argument in favor of the tuber- 

 culin treatment is required. It should be remembered, moreover, 

 that the actual results were probably still better than is suggested 

 by the above figures, if we consider that the improvement continues 

 for three or four months after the treatment is suspended. They 

 might have been still better, as Bandelier suggests, if the limit of 

 immunization, i. e., the maximal dose of tuberculin had been higher 

 than 10 milligrams, which had been chosen as standard. 



Of late, systematic efforts have been made to improve the hygienic 

 condition of the tubercular poor, and to give these also the benefit 

 of the tuberculin treatment when living in their own homes. As a 

 consequence the outlook for these unfortunates has been materially 

 improved. Friedrich thus records that of 700 cases of early tuber- 

 culosis which were treated in this manner the disease was arrested 

 or the patients much improved in 51 per cent, of the cases. Similar 

 results have been reported from other sources. 



