Tuberculin in diagnosis and treatment : a text-book of the specific diagnosis and therapy of tuberculosis for practitioners and students / By Dr. Bandelier ... and Dr. Roepke.

  • Bandelier, B. (Bruno), 1871-1924.
Date:
1913
Catalogue details

Licence: Public Domain Mark

Credit: Tuberculin in diagnosis and treatment : a text-book of the specific diagnosis and therapy of tuberculosis for practitioners and students / By Dr. Bandelier ... and Dr. Roepke. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    33/350 (page 13)
    A.- -Theories of Tuberculin Reaction. 1.—CHANGES IN THE TOXIN-SENSITIVE CELLS. In his classical studies on tuberculosis, Koch. Koch noticed the cellular changes following a tubercular infection. He writes [3] : — When a healthy guinea-pig is inoculated with pure culture of tubercle bacilli the wound usually closes up and seems during the first few days to heal up. But in about ten to fourteen days there appears a hard nodule which soon breaks down, forming an ulcer which persists till the death of the animal. But the result is quite different when an already tubercular animal is inoculated. The most suitable animals are those which have been successfully infected some four to six weeks previously. In such animals the wound also heals at first, but forms no nodule, and on the following or second day peculiar changes take place at the site of inocula- tion; it becomes hard and assumes a dark colour, not limited to the site itself, but spreading to the surrounding tissue to a diameter of o. 1 to 1.0 cm. During the next few days it becomes clearer and clearer that the changed skin is necrotic; it is eventually shed and there remains a flat ulcerated area, which usually heals quickly and lastingly without infecting the neighbouring lymphatics. After Koch came Buchner [4], who came Buchner. to much the same conclusions as we hold to-day : — In order to give it a designation, we can for the present define this condition (after recent infection) as latent irritation caused by the tubercle bacilli present in the body. Of the latter there must always be a propor- tion which encounter unfavourable conditions for life and will degenerate and die, when their proteins will be set free and become active. The latent irritation caused by this is in its nature not a passive condition, but the expression of a reaction of the tissue elements, by means of which the latter attempt, although unsuccessfully, to free themselves from the exciting cause of infection. Buchner, too, drew attention to febrile symptoms as a sign of tuberculin reaction. Then followed the further observation that the same pheno- mena as appear after the re-injection of living and dead bacteria can be produced with their extracts—tuberculin. R.. Koch was again the first to give details of this, but it remained for the later researches in immunity to separate the general from the cellular