382 Tuberculosis 



In speaking of his experiments upon guinea-pigs, Koch 

 says: 



"I have, in general, got the impression in these experi- 

 ments that full immunization sets in two or three weeks 

 after the use of large doses. A cure in tuberculous guinea- 

 pigs, animals in which the disease runs, as is well known, 

 a very rapid course, may, therefore, take place only when 

 the treatment is introduced early as early as one or two 

 weeks after the infection with tuberculosis. 



"This rule avails also for tuberculous human beings, 

 whose treatment must not be begun too late. ... A 

 patient who has but a few months to live cannot expect 

 any value from the use of the remedy, and it will be of 

 little use 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." 



One very serious objection, first urged against commer- 

 cially prepared TR by Trudeau and Baldwin,* is that it is 

 possible for it to contain unpulverized, and hence still living, 

 virulent tubercle bacilli. Thelling f could not observe any 

 good effect to result from the use of Koch's new tuberculin, 

 and, like Trudeau, found living, virulent bacilli in the prepa- 

 ration secured from Hochst. Many others have since dis- 

 covered the same danger. In the preparation of the remedy 

 it will be remembered that no antiseptic or germicide was 

 added to the solutions, by which the effects of accidental fail- 

 ure to crush every bacillus could be overcome, Koch having 

 specially deprecated such additions as producing destruc- 

 tive changes in the TR. Until this possibility of danger can 

 be removed, and our confidence that attempts to cure 

 patients may not result in their infection be restored, it be- 

 comes a question whether TR can find a place in human 

 medicine, or must remain an interesting laboratory product. 

 Baumgarten and Walz J find that the administration of 

 tuberculin-R to guinea-pigs is without curative effect. 

 They insist that the results obtained are like those of the 

 old tuberculin; that "small doses are of no advantage, 

 while the larger the doses one employs, the greater are the 

 disadvantages that result from their employment." 

 * "Medical News," Aug. 28, 1897. 



t "Centralbl. f. Bakt.," etc., July 5, 1902, xxxn, No. i, p. 28. 

 J "Centralbl. f. Bakt. und Parasitenk.," April 12, 1898, xxm, No. 

 i4> P- 593- 



