Antitubercle Serums 683 



Agglutination. — Arloing* and Courmontf found it possible to 

 prepare homogenized cultures of the tubercle bacillus, and saw them 

 agglutinated by the serUm of immunized animals and by the serum 

 of tuberculous patients. The subject was investigated by Koch,f 

 who carefully reviewed the details of technic and investigated the 

 method, which, he concluded, was valueless for the diagnosis of 

 human infection, though a good guide to the extent of immunization 

 achieved by the therapeutic administration of tuberculin-R. Thel- 

 ling§ has also shown the reaction to be too irregular to be of practical 

 diagnostic importance. 



The technic of the agglutination test as given by Koch|| is as 

 follows: 



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

 ment: CoUect the bacillary masses upon a filter-paper and press between layers 

 of filter-paper to remove the fluid. Weigh out, say, o. 2 gm. of the solid mass and 

 rub it in an agate mortar, adding, drop by drop, a J^q 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 oS, and rendered 

 feebly alkaline by adding diluted hydrochloric acid solution. The fluid thus 

 obtained is too concentrated 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, 

 1:200, 1:300, 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,** Bernheim,tt 

 Paquin,tJ Viquerat§§ and others have experimented in various ways, 

 hoping that the principles of serum therapy might apply to tuber- 

 culosis. Nothing has, however, been achieved. Maragliano's|| || 

 antitubercle serum has been used in a very large number of cases in 

 human medicine, but the glittering results reported by its author 

 have not been confirmed. Behring*** comments upon it by saying 

 that " Maragliano's tubercle antitoxin contains no antitoxin." 



* "Congress de m6d. int. Montpellier," 1898; "Compt. rendu Acad, de 

 Sciences de Paris," 1898, T. cxxvi, pp. 1319-1321. 



t "Compt. rend. Soc. de Biol, de Paris," 1898, No. 28, v; "Congr. pour 

 I'etude de la Tuberculose," Paris, 1898. 



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

 § Loc. cit. 



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

 ** "Centralbl. f. Bakt.," etc., 1892, Bd. xi, p. 82. 

 ft "Ibid., 1894, Bd. XV, p. 654. 

 tt "New York Med. Record," 1895. 



§§ "Zur Gewinnung von Antituberkulin, Centralbl. f. Bakt.," etc., Nov. s, 

 1896. XX, Nos. 18, 19, p. 674. 



III! "Berliner klin. Wochenschrift," 1895, No. 32. 

 *** "Fortschritte der Med.," 1897. 



