OPSONIC INDEX AND VACCINE THERAPY 357 



TUBERCULIN BACILLARY EMULSION 



This preparation consists of a combination of T O and T R. It 

 represents an emulsion of pulverized tubercle bacilli in 100 parts of 

 50 per cent, glycerin. The preparation as marketed contains 0.005 

 gram solid substance to the cubic centimeter. It is prepared simply 

 by mechanically grinding the bacteria as in the new tuberculin, but, 

 instead of centrifugalizing for the separation of T O and T R, the 

 bacteria are allowed to sediment after the addition of glycerin. This 

 is the preparation which is extensively used in many places at pres- 

 ent for the treatment of tuberculosis. It was adopted by Koch par- 

 ticularly because of experiments in which he showed that the treat- 

 ment of animals with such preparations greatly increased the ag- 

 glutinins for tubercle bacilli. 



BOUILLON FILTRE (DENYS) 



Denys cultivates the tubercle bacilli upon 5 per cent, glycerin 

 bouillon as in the preparation of old tuberculin, but does not heat, 

 sterilizing his cultures by filtration through porcelain. Denys be- 

 lieves that the application of heat in sterilization destroys exotoxins 

 which have valuable antigenic properties. 



SENSITIZED TUBERCULIN 



Following the introduction of sensitized vaccines in other dis- 

 eases by Besredka, Meyer 39 has introduced the sensitized tuberculin. 

 This tuberculin is prepared in the following way : Tubercle bacilli 

 of the human type are washed and dried and are mixed with a con- 

 siderable quantity of the serum of animals immunized with tubercle 

 emulsions and containing considerable quantities of tubercle-agglu- 

 tinins. These serum mixtures are kept at 37 C. for several days 

 and are then shaken in a shaking machine until intact tubercle bacilli 

 are no longer to be found. The tubercle bacillus fragments are then 

 thrown down in the centrifuge, washed in salt solution, and emulsi- 

 fied in 40 per cent, glycerin, 0.5 per cent, carbolic acid being used. 

 The emulsion contains 0.005 gram dry weight to a cubic centimeter. 

 We take the description of the preparation from that cited by 

 Bandelier and Roepke. 



The above tabulation contains the most important tuberculin 

 preparations as they are at the present time in use. For detailed 

 studies of their clinical application we refer the reader to the very 

 valuable book of Bandelier and Roepke, "Lehrbuch der spezifischen 

 Diagnostik und Therapie der Tuberkulose," Curt Kabitzsch, Wiirz- 

 burg. 



39 Meyer. Cited from Bandelier and Roepke, "Lehrbuch d. spez. Diagn. 

 u. Ther. d. Tuberkulose," Kabitzsch, Wiirzburg, 6th ed., 1911, p. 186. 



