384 Tuberculosis 



Thelling* "has also shown the reaction to be too irregular 

 to be of practical diagnostic importance. 



The technic of the agglutination test as given by Kochf 

 is as follows : 



Any culture of the tubercle bacillus can be made useful by the fol- 

 lowing treatment: Collect the bacillary masses upon a filter-paper 

 and press between layers of filter-paper to remove" the fluid. Weigh 

 out, say, 0.2 gm. of the solid mass and rub it in an agate mortar, adding, 

 drop by drop, a -fa normal sodium hydroxid solution until the proportion 

 of i part of the culture to 100 parts of the solution is reached. 



It is necessary that the rubbing be thorough in order that the firm 

 connection between the bacilli shall be broken up and the organisms 

 distributed throughout the fluid. The operation usually lasts fifteen 

 minutes. The fluid is then placed in a hand centrifuge and whirled 

 for six minutes, then pipetted off, and rendered feebly alkaline by adding 

 diluted hydrochloric acid solution. The fluid thus obtained is too con- 

 centrated to be used in this form, so must be diluted with 0.5 per cent, 

 carbolic acid in 0.85 per cent, sodium chlorid solution. This solution 

 should be repeatedly filtered before receiving the bacillary suspension. 

 The quantity of bacillary suspension to be added should make the final 

 product a 3000 dilution of the original. It should look like water by 

 transmitted light, but slightly opalescent by reflected light. 



The serum to be tested is added in proportions of i : 10, i : 25, i : 50, 

 i : 75, i: 100, i: 200, i: 300, etc., and is to stand for twenty-four hours. 

 By inclining the tube and looking through a thin stratum of the fluid 

 the agglutinations can be at once detected. 



Antitubercle Serums. Tizzoni and Centanni,J Bern- 

 heim, Paquin,|| and others have experimented in various 

 ways, hoping that the principles of serum therapy might 

 apply to tuberculosis. Nothing has, however, been achieved. 

 Maragliano's ** antitubercle serum has been used in a very 

 large number of cases in human medicine, and many cures 

 as well as improvements are reported. Behringft comments 

 upon it by saying that " Maragliano's tubercle antitoxin 

 contains no antitoxin." 



Babes and Proca.ft in an experimental research upon the 

 action of an an ti tuberculous serum, claim to have observed 

 a decided specific action. 



Maffucci and di Vestea found that by injecting guinea - 



* Loc. cit. 



t "Deutsche med. Wochenschrift," 1901, No. 48, p. 829. 



t "Centralbl. f. Bakt.," etc., Bd. xi, p. 82. 



Ibid., Bd. xv, p. 654. 



|| "New York Med. Rec.," 1895. 

 ** "Berliner klin Wochenschrift," 1895, No. 32. 

 ft " Fortschritte der Med.," 1897. 

 JJ " La Med. Moderne," 1896, p. 37. 

 "Centralbl. f. Bakt.," etc., 1896, Bd. xix, p. 208. 



