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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    In some sanatoria the slight uncomplicated cases are not submitted to tuberculin treatment, but only the severe cases, in which the hygienic- dietetic method alone does not guarantee the highest possible degree of success. In such institutions it is a fact, evident not only to the doctors, but also to the patients themselves, that of those treated with tuberculin—all cases of open tuberculosis—it is seldom that a patient is confined to bed from any indisposition, while of the others, not treated with tuberculin, a certain percentage is regularly bed-ridden. It has lately been asserted in many quar- a ue ° ters, on purely theoretical grounds and in Tox-i mm unity. SUpport of individual theories, that tox- immunity may not be to the advantage of the tubercular patient. We will mention, therefore, the experiments of Pickert [34], who draws attention to the fact, well known to all experienced tuberculin therapists, that patients whose disease takes a con- spicuously favourable course possess a raised natural resistance ?o tuberculin, which speaks for a high resistance of the organism to the disease. This is reminiscent of the fact that we [35] discovered many years ago that a large percentage of slight cases of favourable tendency to heal, which were submitted to the hygienic-dietetic method alone, showed at the conclusion of treatment high tolerance of tuberculin, while, on admission, they were highly sensitive to small doses of tuberculin. From these results we can at once draw the conclusion that also an artificially acquired tolerance of tuberculin cannot be disadvantageous, but that we are undoubtedly on the right road in our therapeutic endeavours. It is our experience that just those patients who tolerate tuberculin well, i.e., in whom it is easy to produce tox- immunity, progress favourably. The tuberculin tolerance is evidently advantageous; it is a sign that the diseased organism —of its own power, or aided by specific treatment, as the case may be—is repelling the toxic action of the tubercle bacilli, that it has acquired a relative tox-immunity. Our view, which has received confirmation vear by year, is shared by many competent authori- ties ; we will onlv mention Sahli and Much of the many authors who attempt to produce tox-immunity in their patients. _ ._ . With increasing tox-immunity, the condi- Two Forms of . . °. ' ,. tion 01 insensitiveness to tuberculin can Insensitiveness to occyr_ We distinguish two forms, also Tuberculin. recognized as such by Hamburger and Monti: (1) A forced incapacity to react; (2) a true immunity. As the cause of the former—the insensitiveness of individuals treated for a long time with tuberculin—Wassermann [5] described the anti-tuberculin circulating in the blood. These amboceptors intercept the tuberculin, neutralize it, and prevent the
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