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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![Kretz [25] then proved that a normal animal does not reply to the injection of an equilibrized mixture of toxin and antitoxin with the formation of antitoxin, while a previously treated animal reacts to the same injection with a copious production of antitoxin. In consideration of this fact, Lowenstein and Rappaport [26] were induced to test the same chain of ideas, using tuberculin. By the repeated injection of the smallest doses of tuberculin, they succeeded in artificially producing a hypersusceptibility of the organism to tuberculin. _.. ,, v. Pirquet [27! coined the word allergie v. Pirquet s . . . . to describe a changed capacity for reaction Allergia. ^^ »pyeta^ Tnis idea of allergia has also been applied to the tuberculin reaction. Just as in animals which have undergone previous treatment with protein, so in the tubercular subject there is an allergical action against the bacterial protein. Thus the cutaneous tuberculin reaction also depends on allergia, i.e., on the altered reaction which the organism gives to the infecting agent, already known to it. The person inoculated for the second time—or the tubercular individual—reacts in point of time, quality and quantity differently from one inoculated for the first time—or the non-tubercular. As long ago as 1903, v. Pirquet and Schick had, on the occasion of the discussion at the Gesellschaft fur Kinderheilkunde (Cassel, 1903), ex- pressed the view that the capacity of the tubercular patient to react to tuber- culin, of the vaccinated subject to vaccine, and of the animal inoculated with horse-serum to serum, were all conditioned by reaction-products of the nature of antibodies. Further clinical investigations on the various forms of reaction to ordinary vaccine lymph led v. Pirquet to the observation that reaction only occurred within twenty-four hours in the case of pre- viously vaccinated subjects, and that this capacity of vaccinal early reaction begins during the febrile period of vaccination and lasts several years. An entirely analogous reaction of hypersusceptibility of the skin (allergie) he observed to occur when, in the tubercular subject, a small quantity of tuberculin was applied cutaneously. At the spot there developed in the skin a reaction remaining localized, an inoculation papule, also based on the principle of the vaccinal early reaction and conditioned by the coming together of toxin (tuberculin) and antibody. The presence of antibody demonstrated by the reaction affords proof of the existence of a previous or still active tubercular infection in the inoculated organism. This is, in its main features, the line of thought which led v. Pirquet to the diagnostic application of allergia in tuberculosis. The latest theory of hypersusceptibility is Friedberger. Friedberger's theory of anaphylaxis. The word anaphylaxis introduced by Richet is applied to the](https://iiif.wellcomecollection.org/image/b21229351_0040.jp2/full/800%2C/0/default.jpg)
