682 Tuberculosis 



Thelling* could not observe any good effect to result from the use 

 of Koch's TR-tuberculin, and, like Trudeau, found living, virulent 

 bacilli in the preparation secured from Hochst. Many others have 

 since discovered 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 failure to 

 crush every bacillus could be overcome, Koch having specially 

 deprecated such additions as producing destructive 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 becomes a question whether TR can find 

 a place in human medicine, or must remain an interesting labora- 

 tory product. 



Baumgarten and Walzf find that the administration of tuber- 

 culin-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." 



During his experiments upon the agglutination of tubercle bacilli, 

 to be descrived below, Kochf found that animals injected with an 

 emulsion of tubercle bacilli showed great increase in the agglutinative 

 power of the blood. This led him to suggest that a new preparation, 

 "hacillary emulsion" Bazillenemulsion, be investigated for its im- 

 munizing and curative properties. Many are still using it and 

 some claim good results. 



It is almost impossible to make an accurate estimation of the 

 usefulness or uselessness of therapeutic preparations of tubercle 

 bacilli at the present time, not only because of their diversity of 

 composition and the enthusiasm with which many have been 

 exploited, but also because of our inability to compare the 

 results attained with any definite standard. The advantages 

 or disadvantages of any preparation, therefore, depend upon 

 the personal opinions of those employing them rather than upon 

 any demonstration regarding them — a very unscientific state of 

 knowledge. 



The suggestion of A. E. Wright that the administration of all such 

 products should be controlled by an examination of the opsonic power 

 of the blood, the remedy being withheld if this was high and applied 

 if low, the utmost care being taken not to prolong the "negative 

 phase," seemed to be an excellent one, affording the beginning of a 

 scientific method of studying the disease, but unfortunately it seems 

 not to have been successful in practice, and the tedium and expense 

 of the examinations makes them impracticable. 



* "Centralbl. f. Bakt.," etc., July s, 1902, xxxii, No. i, p. 28. 



t " Centralbl. f. Bakt. und Parasitenk.," April 12, 1898, xxra, No. 14, p. s,qx. 



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



