The Portland daily press., 1890-11-17
BATTLING WITH A DREAD DISEASE.
What Prof. Koch says of His RENE.
dy for Consumption.
Its Discovers Estimate of Its Pow
ers a Conservative One.
Hope for Those In the Early Stages
of the sickness.

BERLIN, November 15.-The article by
Prof. Koch in this weeks number of the
Deutsche Medinizische Wochenschrift Ger
man Medical Weekly is entitled Further
Communications on the Cure of Tuberculo-
sis and Experiments which DR.. Libbertz and
Staff Surgeon Pruhl Performed Relating
Thereto under Prof. Koch'S Direction"
In this article Prof. Koch says that he is
as yet unprepared to indicate the source
from which the curative matter is derived.
Neither is he ready to explain the method of
preparation. The reason he gives is that the
experimental work has not yet been brought
TO completion. He states, however, that the
curative lymph itself can now be obtained
from DR.. Libbertz. whose address ISIS Luen-
eburger strasse, Berlin
The lymph is described as brownish
transparent liquid. 1t is so prepared as to be
proof against deterioration. When, howev-
er, it is diluted with water to the necessary
degree for use, the matter is liable to decay.
1t is necessary, therefore, that the attenua.
tions should be perfectly sterilized by heat
and preserved in waGding covering, or pre-
pared with a solution of phenol 30 per cent
strong. When taken into the stomach the
must be applied simultaneously by means of
a valveless syringe. The kind of syringe
recommended by Prof. Koch is one furn-
ished with small hollow rubber ball. This
syringe approved itself to him during his
PSYCHOLOGICAL experiments. Its merit is
absolute alcohol and kept in perfectly
aseptic condition. In thousands of cases he
says, where 1t has been used for sub-cutane-
Gus injections, not single abscess resulted.
When the curative matter Is applied to pa
tient, the usual course is to inject it
under the skin of the back between the
shoulder blades and in proximity to the
loins.
The reaction produced in the internal or
gans, especially the lungs, when the curative
substance is injected If not, of course, open
TO observation apart from the increased eX-
pectoratiOn and cough.
In all theexperiments after the first injec-
tions, If any tuberculous process existed in
the body the appearances already described
supervened Absolutely no exception was
noted whenever q dose amounting to one
hundredth part of cubic centimetre of the
substance had been applied. One may as
sert with confidence, therefore, that the
remedy may be considered an indispensable
auxiliary to diagnosis, and, in doubtful cases,
incipient phthisis can positively be dag
nosed by its use, even il positive information
of the nature of the disease cannot be OBJ
tanned by the discovery of bacilli, or of
elastic fibres in the sputUm, or by physical
examination. Tuberculous affections of the
glands, latent tuberculosis of the bones,
doubtful skin tuberculosis, &C., can by the
use of this fluid be easily and certainly
diagnosed. Moreover, in cases of lung or
joint tuberculosis, which have apparently
passed off, 1t will be possible, by the use of
the new substance, to ascertain with certain
ty whether the morbid process is really and
absolutely ended.
Professor Koch expresses the belief that
his remedy will certainly prove a cure for
incipient phthisis, Whether, however, the
cure will he final and definite has not, he
says, been clearly proved. Further expert
be necessary to determine this question.
The curative properties of the new RENE
dy, Professor Koch declares, are of still
greater Importance for diagnosis. What the
fluid kills is not the tubercular bacillus, but
the tubercular tissue. This fact indicates
the well-defined limits which the efficacy of
the remedy will be able to reach. In other
words, it can only influence living tubercu-
losis tissue. 1t has no effect whatever upon
dead tissue, such as decayed Gaseous matter.
necrotic bones, and the like. More than
this, it produces no effect upon tissues which
have already been killed by the application
of the remedy. 1t is quite possible that
such dead tissue may still contain living tu-
berculous bacilli. These may then be either
expelled with the necrotic tissue, or it may
be that under special circumstances they
may again invade adjacent living tissues.
1t follows, therefore. that tuberculOus tis-
sue that is still living must first be made to
decay. When this has been accomplished,
every effort must be made to remove the dead
matter by surgery. In cases where this
method is impossible and secretion can only
slowly proceed by the self help of the organ
ism threatened. the living issue must, at the
same time, be protected by continued appli-
cations of the remedy, so as to guard against
tno rair1 fniO Of
The fact that the remedy causes decay only
Of the tuberculous tissues, affecting exclu-
sively living tissues. explains why the cura--
tive fluid may be applied in rapidly increased
doses.
After the patient has been under treatment
for period of three weeks dose of the
fluid of five hundred times the strength of
the original dose can be applied, for at the
beginning, when large quantity OF living
tissue exists, small quantity OF
the remedy suffices to produce strong reac-
tiOn, but each succeeding Injection causes
the disappearance of a certain quantity OF
tissue capable of reaction. 1t naturally fol-
lows, therefore, that increased doses are ne
cessary to obtain the same degree of reac-
tion. AS soon as patients treated with in
creased doses experience as little reaction as
non-tubercul0us people, 1t may be assumed
that all tuberculous tissue open to reaction
is dead Whether this conclusion is correct,
time will show. For the present, however,
Prof. Koch is convinced that this conclusion
is a correct one.
Patients with pronounced tuberculosis of
the lungs have proved far more susceptible
to the remedy than those suffering with
surgical tubercular affections. Consump-
tives have, in almost every instance, mani.
Tested strong reaction on greatly reduced
doses. With such patients, therefore, be-
ginning should be made with doses of two
one-thousandth parts of cubic centimetre,
or even with one-thOusandth part From
this small, incipient dose one can advance to
such quantities as the patient can easily
bear. In the experiments that have been
conducted consumptives have, accordingly,
first received sub-cutaneous injection OF
one one -thousandth part Of a cubic cent?
metre. Then, when the temperature in
creased, the same dose was applied daily un-
til no further reaction occurred. There
upon the dose was doubled, two 0ne-thou-
sandth parts of a cubic centmetre being in
jected regularly until no reaction occurred.
This method was continued with almost al
ways an increase of one one-thousandth
part of cubic centimetre. or at most two
one-thousandths up to one one-hundredth
part, and so on upward. In this way the
patient would be brought to take very high
doses almost without fever and almost i'm
perceptibly to himself.
Consumptiye patients who are still fairly
strong reach increased doses much more
quickly, and favorable results follow with
corresponding rapidity. AS general rule
the coughing and expectoration are increas-
ed somewhat after the first injections. Then
they become gradually less, and In the most
favorable cases will ultimately wholly disap-
pear.
In the cases experimental upon under the
direction of Professor Koch, the expectora-
tions gradually lost their purulent property,
and assumed mucous character. The num-
Der of bacilli expelled usually decreases on
ly when the approximations begin to assume
the mucous appearance. The bacilli then
disappear entirely for time, but on occa-
sions again appear until expectoratlon to-
tally ceases. At the same time the night
sweats cease, the patients begin to look bet
ter and to increase In weight. Patients who
have been treated in the early stages of
phthisis have all been freed from morbid
symptoms within four to six weeks,
when they may be regarded as healed.
Consumptives with large cavities in their
lungs will probably only experience benefit
from the new remedy in exceptional cases,
though most cases show temporary improve
ment.
Professor Koch deprecates the mechanical
and indiscriminate application Of the rene
dy. He holds that it would be preferable
that the treatment should be applied in suit
aDie institutions, where careful observation
would be possible.
In all cases Professor Koch emphasizes
the necessity OF early treatment. Only in
lnclplent stages OF disease, he declares, can
the remedy fully develop its efficacy.
a BATTLE FOR LIFE.
HOW the Survivors of the Serpent