1905.] On Tubercular Infection in a Patient's Blood, etc. 201 



Table II. — Showing that the Normal Serum, after it has been exposed to a 

 Temperature of 60° C. for 10 minutes, no longer incites Phagocytosis.* 







Unheated serum. 



Heated serum. 



Serial 

 number 

 of the 

 observa- 

 tion. 



Derivation of the 

 serum. 



Phagocytic count. 



(Number of 

 bacteria ingested 



divided by 

 number of leuco- 

 cytes examined.) 



Tuberculo- 



opsonic 

 index. 



Phagocytic count. 



(Number of 

 bacteria ingested 



divided by 

 number of leuco- 

 cytes examined.) 



Tuberculo- 

 opsonic 

 index. 



Healthy man . . 



Pooled serum of six 



healthy men 

 Healthy boy 



Pooled serum of eight 



normal men 



Healthy man 



Pooled serum of six 



healthy men 



(104/40) 



= 2-6 



(96/40) 



= 2-4 



(247/36) 



= 6-8 



(250/39) 



= 6-4 



(214/30) 



-7-0 



(60/50) 



= 1-2 



(55/40) 



= 1-4 



(132/30) 



= 4-4' 



Taken as 1 

 1 

 1 



1 

 1 

 1 



1 

 1 



(13/40) 



= 0-32 



0-125 



(8/40) 



= 0*2 



0-08 



(30/50) 



= 0-6 



0-09 



(15/40) 



= 0-4 



0-06 



(19/40) 



= 0-47 



0-06 



(2/20) 



= 0-1 



0-08 



(0/40) 



= 00 



o-oo 



(3/30) 



= 0-1 



0-1 



evidence of that reaction can be obtained by conducting the phagocytic test 

 with serum which has been heated to 60° C. for 10 minutes. 



The observations numbered 15 and 16 respectively have, it may be noted, 

 been introduced into the table with the special design of showing the very 

 simple nature of the investigation which is required for the diagnosis of 

 tubercle in the case where that infection has called forth a reaction of 

 immunisation. 



The following observations, which we owe to our fellow-worker 

 Dr. G. W. Eoss, bring out in an instructive manner the trustworthiness 

 of the phagocytic test with heated serum as applied in this its simplest 

 form : — 



Case 1. — Girl, cet. six years, Tentatively Diagnosed Pulmonary Phthisis. 



Phagocytosis obtained with the serum, heated for 10 minutes to 60° C. and 

 employed in a phagocytic mixture containing over 1 per cent. NaCl. 



The verdict of tubercular infection of the lung which was based on this 

 was confirmed on post-mortem examination. 



* In order to avoid the fallacies associated with spontaneous phagocytosis {vide the next 

 following communication) the observations which are recorded in this and in the subsequent 

 table were in each case made by mixing the volume of the serum with one volume of 

 corpuscles, washed in - 85-per-cent. NaCl solution and one volume of tubercle bacilli 

 suspended in a l^-per-cent. NaCl solution. In this manner a salt content of over 1-per- 

 cent. NaCl was achieved in the phagocytic mixture. 



