Pittsburg dispatch. [volume] (Pittsburg [Pa.]) 1880-1923, 1891-07-11

regard the freedom from accidents and the
excellent results only as the exceptional
good fortune of few, and as the usual effects
of care in regard to air, diet, etc.
the more probable outcome of the investiga-
ton. Some of the severest blows that have
been dealt the Koch treatment have come
from those who recklessly disregarded the
directions of its originator. For example,
DR.. Detweiler, the director Of sanitarium
for conservatives at Falkenstein, who after
Virchow has done more than anyone to
arouse prejudice against the lymph, used 1t
in all of the 12S cases of consumption under
his charge A of whom were admittedly
quite advanced, and only 15 incipient.
Moreover. according to his own confession,
the new treatment was carried out accord
ing to definite general scheme, so that the.
patients were, to use his own expression,
s'nothing bu. syringe numbers" thus going
exactly contrary to Koch's advice to care
fully individualize. A more recent opponent
of tuberculin, DR.. Heuck, of Heidelberg,
used the remedy in 81 far advanced and u
moderately advanced cases, out of total
of &c.
Heuck Convinced of Dangers.
Of these nine died under treatment, and,
as a consequence, Heuck is firmly convinced
of the dangers attending the use of the
tuberculin, there being, for him, apparently
little significance in the fact that of his IL
incipient cases seven were very markedly
improved, while only two retrograded. The
experience of DR.. Furbringer, of Berlin, is
also very suggestive In this connection.
During the first few months using the new
remedy II patients died. Later he reports
that 'Ffor five weeks no death has occurred,
apparently because of more restricted
choice of cases and more careful indiyidu-
alizing, together with the use of smaller
doses"
On the other hand, an attempt to explain
away the improvement noted in so many
cases seems not at all likely to succeed,
whether it be argued that the results are due
to other causes, or that equally good have
been obtained by other methods There are
abundant instances of patients under treat
ment in hospitals and sanitaria who showed
no improvement until after the use OF tuber-
culin was begun. For example, Furbringer,
in his hospital practice, noted, in 40 per
cent of the cases treated during the winter,
an improvement such as he had never, or
very rarely, seen in previous winters; and
the new method, he asserts, caused an un-
mistakable change in the complexion of the
hospital statistics. In his private practice,
too, he noted improvements in patients
whom residence in high attitudes and
southern regions had not benefited. In this
connection it is also worthy of note that Dr.
Turban, of Davos, and DR.. Wolff, of Cor
bersdorf. consider that by supplementing
the ordinary climatic treatment, for which
these resorts are famous, with the use of
tuberculin, they have secured an increase OF
favorable results
Koch,s Remedy of Real Value.
1t would seem then that the positive value
of Koch's discovery is impossible of denial.
1t is not so easy, however, to assert that
physicians are now able, in the light of past
experience, to so select their cases,and con-
duct the treatment that all danger of mis-
hap is avoided. 1t is true that this danger
is now reduced to minimum, as shown by
a recent report of DR.. Guttmann, of the
Moabit Hospital, in Berlin. His method of
using very small dose-one-tenth of a..
millgram-at the beginning, and increasing
only one-tenth at each succeeding injection,
has not been followed by single mishap,
and the &c cases treated all showed some
improvement especially in the matter of
weight. This experience, however, does
not prove that danger can be absolutely pre-
vented. The suspicion must still remain
that, for reasons yet unknown, the injection
of tuberculin is liable to cause serious COM
plications even in cases deemed wholly fit
whether any never-failing sign Of contra
indication of tubereulin can be discovered
or the drug be purified of its dangerous ele-
ments without eliminating the active prin-
ciple.
In both directions there is good ground
for hope; and, in any event, it is inconceiv-
able that science should wholly give up the
advantage of possessing a substance that has
a specific action on tubercular tissue. In
the combination of the use of this specific
with the constitutional treatment of the
past is found the best way of opposing TIE
ravages of consumption that present knowl-
edge permits SIN this union," says DIR.
Klemperer, 81 see the signs by which the
modern clinic will conquer"
Statistics of the Treatment.
A presentation of the statistics which fur
nish the basis of the preceding discussion
may not be without interest. Below will
be found as accurate a compilation as the
circumstances will permit of the result re-
ported during the last three months.