The bacterial diseases of respiration, and vaccines in their treatment / By R. W. Allen.
- Allen, R. W., 1876-1921.
- Date:
- 1913
Licence: Public Domain Mark
Credit: The bacterial diseases of respiration, and vaccines in their treatment / By R. W. Allen. 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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![sary antibodies. The period of disease at which the body can best per- form this task is, as Koch so strongly urged, in the early stages of a strictly localised infection. In the earliest stages of miliary tubercu- losis Koch detected a definite attempt on the part of the body to elaborate specific antibodies, but this power is soon lost and the cells can no longer respond to stimulation, as is clearly shown by their failure to react to the various diagnostic tests. For a similar reason in cases of advanced cachexia tuberculin is of no avail. ]ylany authorities would restrict the use of tuberculin to uncompli- cated afebrile cases in Stages I and II of Turban, i. e. to cases whose temperature does not rise above gg° F., in which cavitation has not yet occurred, and where the process is confined to not more than two lobes. Others would exclude all cases in which mixed infection is present, but fail to realise that mixed infection is almost certainly present in all cases of open tuberculosis, and inasmuch as they administer the drug to many such cases obviously fail to observe their own dictum. Mixed infection, per se, is no contra-indication to the use of tuberculin, but, as we have seen in Chapter X, so complicates the control of dosage and intervals by obscuring the focal and general reaction thereto that the difficulty of administration is immensely increased. Actively progressive forms of the disease are not likely to be bene- fited, but advanced forms where much destruction has occurred may recover, provided the destruction falls somewhat short of that degree in which pathological anatomy shows that spontaneous cure or arrest may take place. The best method of classification is that based upon a consideration of the nature of the processes which are occurring at the foci of disease and of the manner in which the body is responding to the infection ; such an one is that proposed by Inman, who divides cases into the following three classes: Class I : Resting febrile, i. e. those which show a temperature of 99° F. or over when at rest in bed. Class II: Ambulant febrile, resting afebrile, i.e. those which remain afebrile so long as they are at absolute rest, but become febrile when allowed to get up and take exercise. Class II is often a transi- tion between Classes I and III. Class III: Ambulant afebrile, i. e. those without fever in spite of exercise or work. The febrility of tuberculosis is, as Inman and Paterson have shown, due to auto-inoculations with specific products from the bacilli at the foci of disease, but it is necessary to take a somewhat wider view of what constitutes the auto-inoculations than is done by these observers. They appear to regard them as being composed of the products of the tubercle bacilli alone, whereas in many cases they also consist](https://iiif.wellcomecollection.org/image/b21231096_0252.jp2/full/800%2C/0/default.jpg)
