Democratic Northwest. [volume] (Napoleon, Ohio) 1869-1894, 1890-12-25

Iron Medical Reeold.l
The Inoculation Method OF Treating
Tuberculous Disease. by Professor
DR.. Robert Koch, Berlin.
NATURE AND PHYSICAL CHARACTERS
OF THE REMEDY.

/
| OF THE REMEDY.
As regards the origin and the pre-.
paration Of the remedy am unable To
make any statement, rs my research
is not vet concluded; I reserve this fol
a future communication. The remedy
Is brownish transparent liquid, which
does not require special care to prevent
decomposition. For use this fluid must
be more or less diluted, and the dilu-
tions are liable to decomposition IL pre-
pared with distilled water; bacterial
growths soon develop In them, they be.
come tu-bid, and are then unfit for use.
To prevent this the diluted liquid must
be sterilized by heat and preserved un-
der cottonwood stopper; or more con.
Yeniently prepared with halfper cent
solution of phenol.
MANNER OF USING THE REMEDY.
It would seem, however, that the
effect is weakened both by frequent
heating and by mixture with pbenol
solution, and have therefore always
made use of freshly prepared solutions.
introduced into the stomach the RENE
dy has no effect; In order to obtain a
reliable effect 1t must be injected subcu-
taneously. For this purpose we have
used exclusively the small syringe sug-
gested by me for meteorological work;
tits furnished with small india-rubber
ball, and has no piston. This syringe
can easily be kept aseptic by obsolute
alcohol, and to this we at
tribute the fact that not a single alb
scess has been observed In the course of
more than a thousand subcutaneous in
jections. The place chosen for the
injectior-after severals trials of other
places-was the skin of the back be-
tween the shoulder.blades and the lum-
bar region, because here the injection
led to the least local reaction general
ly none at all-and was almost painless.
EFFECT OF INJECTIONS IN HEALTHY
INDIVIDUALS.
AS regards the effect of the remedy
on the human patient. it was clear
from the beginning of the research that
in one very important point the human
being reacts to the remedy differently
from the animal generally used in ex-
perlments-the guinea-pig-a new
proof for the experimenter of the all
important law that experiment on
animals is not conclusive for the hu-
man being; for the human patient
proved extraordinarily more sensitive
than the guinea-pig as regards the effect
of the remedy. A healthy guinea-pig
will bear two cubic centimetres, and
even more, Of the liquid injected sub
cutaneously without being sensibly af-
fected; but in the case of a full-grown
healthy man, OPS cubic centimetre
suffices to prrduce an intense effect.
Calculated by body weight, the 1,50Oth
part of the quantity which has no ap-
preciable effect on the guinea-pig acts
powerfully on the human being. The
symptoms arising from an injection of
OPS cubic centimetre I have observed
after an injection made in my Own up
per arm. They were briefly as follows:
Three or four hours after the injection
there came on pain in the limbs,
fatigue, inclination to cough, difficulty
in breathing. which speedily increased.
In the fifth hour an unusually violent
attack of ague followed, which lasted
almost an hour. At the same time
there was sickness, vomiting, and rise
of body temperature up to 39.6o G. AT
ter twelve hours all these symptoms
abated. The temperature fell, until
next day it was normal, and feeling
of fatigue and pain in the limbs con-
tinued for few days, and for exactly
the same period of time the site of in
lection remained slightly painful and
red. The lowest limit of the effect of
the remedy for a healthy human being
is about 0.0l cubic centimetre (equal to
l cubic centimetre of the hundredth
solution, as has been proved by num-
erous experiments. When this dose
was used, reaction in most people
showed itself only by slight pains in
the limbs and transient fatigue. A few
showed a slight rise of temperature up
to about $50 G. Although the dosage
of the remedy shows great difference
between animals and human beings
calculated by body weight-in some
other qualities there is much similarity
between them. The most important
of these qualities is the specific action
of the remedy on tuberculous processes
of whatever kind.
THE SPECIFIC ACTION ON TUBERCULoUs
PROCESSES.
Twill not here describe this action as
regards animals used for experiment,
but I will at once turn to its extraordi-
nary action on tuberculous human be-
ings. The healthy human being reacts
either not at all or scarcely at alias
we have seen when 0.01 cubic cent?
metre is used. The same holds good
with regard to patients suffering from
diseases other than tuberculosis, as re-
peated experiments have proved. But
the case is very different when the dis
ease is tuberculosis; the same dose Of
0.O1 cubic centimetre, injected subcu-
taneously into the tuberculous patient,
caused a severe general reaction, as we'll
as a local one. Il gave children aged
from two to five years, One-tenth of
this dose, that is to say, 0.00l cubic CEN
Itimetre; very delicate children only
00005 cubic centimetre; and obtained a
powerful, but in no way dangerous, re-
action.) The general reaction consists
in an attack of fever, which, generally
beginning with rigors, raises the tenn
perature above 39o, often up to 400, and
even 41o c.; this is accompanied by
pain in the limbs, coughing, great
fatigue, often sickness and vomiting.
In several cases slight icteric discol-
oration was observed, and occasionally
an eruption like measles on the chest
and neck. The attack usually begins
four to five hours after the injection and
lasts from twelve to fifteen hours. Oc-
casionally it begins later, and then runs
its course with less intensity: The