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
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.
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![organism, in spite of the presence of the disease : the absence of reaction is caused by the fact that anti-tuberculin is present in the serum and arrests the tuberculin before it can reach the focus of disease. The statements of Liidke [7] bear this out : that reactivity to injected tuberculin is generally maintained when no anti-tuberculin can be found in the serum, and that conversely it is just in those cases where anti-tuberculin is proved to be present in the serum that the tuberculin injections are borne with little or no reaction. In addition, Bauer [8] found in his research ' in complement fixation in children's tuber- culosis that with the appearance of a fair quantity of anli- tuberculin in the blood, the reactivity of the organism to cutaneous and subcutaneous tuberculin decreased. In tubercular adults the antibody causing fixation of comple- ment also appears spontaneously, i.e., without previous specific treatment, in the serum and exudates. Since these observations of Wassermann, Citron, Bruck, Liidke, Michaelis, Leonor, and Wolff-Eisner were made chiefly on cases with severe lesions and miliary tuberculosis, the absence of reaction to subcutaneous tuberculin in advanced cases is also intelligible. Antigen and antibody may unite in the serum and cause the neutralization of the tuberculin to take place in the blood, not in the diseased tissues; thus both local reaction in the focus of disease and general reaction are prevented. But even in cases not so far advanced, the tuberculin-neutralizing antibodies act upon the hypersensitizing substance and tend to prevent a tuber- culin reaction. On this depends the necessity of individualizing the doses of tuberculin used for diagnostic purposes. ~. . .. The researches of Wassermann and Bruck Objections to . . . , .,-,,. ... , and their bearing on the action of tuberculin Wassermann s . . ■ , . , TTr have not remained uncontested. We may Theory. refer to tne objections of Weil and Naka- jama [9] and Morgenroth and Rabinowitsch [10], which, how- ever, seem in the main unsound. The doubts they express as to the specificity of the antibodies in particular are shown to be unjustified by the serological investigations of Engel and Bauer [11] on children at the Diisseldorf Academy. Thev never found spontaneous antibodies in the blood of a tubercular suckling or young child—in contradistinction to the adult phthisical patient—never in healthy children, and never in cases of syphilis and pneumonia. On the other hand, anti- bodies were produced in the blood of all tubercular children by the injection of tuberculin, which attained the maximum](https://iiif.wellcomecollection.org/image/b21229351_0035.jp2/full/800%2C/0/default.jpg)
