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.

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    phenomenon of hypersusceptibility which occurs after injection of solutions containing foreign protein, discovered by v. Behring some time previously. The change of terminology—hypersuscep- tibility to anaphylaxis—is rather unfortunate; for anaphylaxis denotes lack of protective power, while hypersusceptibility is almost the exact reverse. Friedberger [28] considers the hyper- susceptibility the result of the anaphylatoxin arising by the action of antibodies from the foreign protein injected. According to his view, the tuberculin reaction takes place as follows : The antibodies formed by the tuberculin injection set free toxin from the tubercle bacilli in the focus, which cause the focal and general reaction. This hypothesis of hypersusceptibility to tuber- culin is disputed by some authors. Thus Bessau holds that it is bound up with the tubercular inflammation, while the condition of reduced susceptibility to tuberculin is non-specific and to be considered as anti-anaphylactic. We hold that the lasting insusceptibility of specifically treated patients is an argument against Bessau's interpretation and proves its real nature—a phenomenon of immunity. Friedberger and his co-workers object to the technique of Bessau's experiments, in which the specific anti-anaphylaxis is only partially masked by non-specific resis- tance and, in a series of important researches [29], bring forward new experimental proofs which still further establish the doctrine of the specificity of anti-anaphylaxis. Further objections have been made against Objections. t^e theories which give hypersusceptibility as the cause of the tuberculin reaction, of which the most impor- tant is that which urges that the passive transference of hyper- susceptibility to tuberculosis in man or guinea-pig has hitherto proved impossible. Our own experiments in this direction have also all been negative. However, we ought not summarily to reject the connection between the tuberculin reaction and protein anaphylaxis. It is doubtless present in allergia in the sense of v. Pirquet, so that it can onlv be concluded that the sub- cutaneous and cutaneous reaction cannot be identified. Quantita- tive conditions, other unknown factors and also the immediate absorption and diffusion of subcutaneous tuberculin in the body may play a part. It is also striking that the tuberculin reaction is accompanied by fever, while a fall of temperature is characteristic of hyper- susceptibility. But this collapse temperature is not uniformly regular in its appearance. Friedberger and Mita succeeded in proving that, also in ordinary protein anaphylaxis, guinea-pigs react with fever to very small doses on the second injection.