390 A MANUAL OF BACTERIOLOGY 



Tuberculosis is diminishing among the white races, but is 

 tending to spread among many coloured races. It is to be noted 

 that the decline in this country began long before the germ origin 

 had been demonstrated, and, what is more, the rate of decline 

 was almost as great before any administrative measures were 

 taken as since. Nevertheless, it can hardly be doubted that 

 measures should be adopted by local authorities and others to 

 prevent the spread of tuberculosis. All forms of tuberculosis are 

 now notifiable in this country. Patients should be warned of the 

 danger of disseminating their expectoration, and should use 

 pocket-spittoons containing an antiseptic, or handkerchiefs (such 

 as the Japanese paper ones) which can be destroyed. Rooms 

 which have been inhabited by tuberculous patients should be 

 disinfected, for which purpose Delepine recommended spraying 

 with a 1-100 solution of chloride of lime. Although the occur- 

 rence of direct infection can rarely be proved, the possibility of 

 this cannot be ignored. Not only should the dissemination of 

 infection be prevented, but the resistance of the individual should 

 be raised by providing a healthy environment and by inculcating 

 the importance of fresh air. 



Serum therapeutics and vaccine. Many sera have been 

 introduced for the treatment of tuberculosis, e.g. Mara- 

 gliano's, Marmorek's, Spengler's, Mehnarto's, etc. Speng- 

 ler's I.K. serum is of considerable value in many cases : 

 it is prepared by immunising rabbits by intramuscular 

 injections and contains the laked red-corpuscles as well 

 as the serum. 1 Mehnarto's is stated to be a mixture of 

 sheep and snake serums and is reported favourably on by 

 Barcroft. 2 



For vaccine treatment, tuberculins R and BE are usually 

 employed (p. 374). Latham has found that tuberculin 

 given per os produces its characteristic effects. 



Immunity. Attempts have been made from time to 

 time to produce immunity against the B. tuberculosis, 



1 See Treatment of Tuberculosis by Immune Substances (I.K.) Therapy. 

 Fearis (John Murray, 1912). 



2 British Journ. of Tuberculosis, 1913. 



