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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    produces, wherever it meets with other albumoses, i.e., in the tubercular focus, a local reaction; it also flushes albumoses out of these areas, causing a general febrile reaction. This explanation bears a close analogy to Wassermann's theory, but it takes no account of the differences between the albumoses and tuberculin already recognized by Zupnik [33] and Matthes and Krehl [32], differences which prove that tuberculin must contain something specific. For instance, in order to obtain a toxic albumose effect, much greater doses are necessary than are employed in the diagnostic use of tuberculin. This Krehl, Matthes, Beraneck, Freymuth, and Landmann have pointed out. A tubercular animal which reacts with fever to 1 mg. old tuber- culin, and to 10 mg. peptone, receives in the tuberculin injection 1/10 mg. of peptone, the hundredth part of the amount of pep- tone necessary to promote a peptone reaction. The final blow to the albumose theory is given by the fact that with albumose-free tuberculin prompt specific results can be obtained. In reviewing the various explanations of Conclusions. tjie tuberculin reaction, Wassermann's theory still seems to have a satisfactory theoretical foundation. In strict contrast to the albumose theory, it asserts the specificity of the tuberculin reaction and of tuberculin itself, which has, moreover, been demonstrated by so many experiments that it must be looked upon as an axiom. A further point is that specific hypersusceptibility has an application in harmony with the experience of tuberculin treat- ment. The constant and uniform factor in all tubercular subjects is the presence of antibodies, the variable factor through all shades of difference the hypersusceptibility. The latter is only the factor which determines the quantitative reactivity of the organism, while the qualitative factor is the presence of anti- bodies in the tubercular individual, be these designated anti- tuberculin, complement-fixing reactionary bodies, albuminolytic or bacteriolytic amboceptors, or sessile receptors. But at any rate the degeneration of the tissues themselves is a partial cause of the hypersusceptibility shown by the tubercular organism. As far, then, as our present knowledge goes, the explanation of the specificity of the tuberculin reaction is essentially associated with the relations between the preparation of tubercle bacilli injected and the tubercular body or tissues saturated with anti- bodies. And these relations ultimately bring us back again to the phenomenon of hvpersusceptibility, the laws of which are not yet fully defined.