Prof. Watson, Dr. Koch's Cure. 335 



was absent from Berlin. At his laboratory, however, he was repres- 

 ented by Dr. Libbertz, from whom, by the kindness of Sir Arthur 

 Blyth and Sir Edward Malet, the English Ambassador at Berlin, I 

 received the supply of lymph which I had the pleasure of forwarding' 

 to you last January. The consensus of opinion amongst the leading 

 hospital physicians and surgeons of Berlin whose experiments we had 

 an opportunity of seeing (I refer to Professors von Bergmann, Barde- 

 leben, Gerhardt, Leyden, Senator, Levy, and others) was that Professor 

 Koch's remedy was useful, but not infallible in diagnosing tuberculosis 

 from syphilis, cancer, and other diseases. As regards its therapeutic 

 usefulness in consumption they agree that its application in picked 

 cases of commencing phthisis occasionally effected, if not an absolute 

 cure, an improvement, but that in advanced cases the remedy was 

 useless if not dangerous. In tuberculosis of parts other than the 

 lungs, such as the skin, bones, glands, and other viscera, they held 

 that there was a great improvement in isolated cases, but that 

 in the majority of cases the condition was not altered for better 

 or worse. — Turning to the pathological aspect of the question: 

 I may say that opportunities of examining the morbid anatomy of 

 cases subjected to Professor Koch's treatment were less frequent in 

 January than they had been in November, when the excitement oc- 

 casioned by the professor's discovery was at its height, and when 

 cases of advanced phthisis had been subjected to the new remedy. 

 I was fortunate, however, to be able to attend demonstrations by 

 Professors Virchow and Orth on the morbid anatomy of cases which 

 had succumbed after, but not necessarily of, the injection of Koch's 

 fluid. Both these pathologists inclined to the opinion that the nature 

 of the changes that occurred in the human subject after the injection 

 of Koch's fluid were not the same in all respects as those which 

 followed Professor Koch's experimental injections in animals. They 

 also pointed out that by the disintegration of tubercular tissues usu- 

 ally following inoculation the bacilli, which, according to Professor 

 Koch, are not killed, might be set adrift and be carried away by the 

 circulation and so set up fresh tubercular eruptions in other parts of 

 the body. Apart from the risk of the above bacillary dissemination, 

 a second danger occurs when the lung is the seat of the disease, 

 because the air tubes may be inadequate to a complete expectoration 

 of all the softened tubercular debris produced by the process of 



