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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    examination, and in almost every laboratory a different opsonic index was found; some gave it as positive, some as negative, the variation being from o'8 to i'j. In this way the opsonic index loses its practical value for a large section of practi- Significance. tioners who can and must take part in the specific treatment of tuberculosis. Its place as a difficult clinical method is in special institutions with assistants working at it alone, thus losing its significance in the treatment of a widespread disease. These considerations do not detract from the scientific value of Wright's teaching nor the forward step thus taken; it is calculated to confirm and intensify the conception held to-day of the beneficial effect of tuberculin in general, and especially to justify and strengthen the modern principle of a carefully graduated tuberculin treatment. We are of the same opinion as Neufeld [43], and for the present value the appearance of opsonins during specific treatment with tuberculin only in the sense that we conclude from their appearance, just as from that of agglutinins, that a specific reactive process is certainly taking place in the organism without, however, any certainty that the opsonins are the immunizing substances which immediately bring about the healing process, and without even admitting that the quantity of these is a direct expression of the degree of immunity attained. Even Wright and his pupils have given up the constant control of the opsonic index in the treatment of chronic cases of tuberculosis. (d) Phagocytosis. Importance of Pha8ocytosis, in Metchnikoff's sense, has ' . in any case a role in the mechanism of ° . ' immunity in tuberculosis during specific MetchmkofT. treatment, and we hold it to be of greater practical importance than the complicated determination of the opsonic index, as well as much simpler to demonstrate. But its significance is not nearly sufficiently recognized and explained. According to v. Baumgarten, phagocytosis has no bacteri- cidal action on the bacteria, the destruction taking place in the serum. From his investigations he concludes that the phagocytes at most digest dead organisms, and that phagocytosis disappears altogether in the immunized organism. Other investigators, however, state that its utility cannot be doubted, whether it eliminates the tubercle bacilli from the circu- lation and prevents their increase, or whether, according to 3
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