Pittsburg dispatch. [volume] (Pittsburg [Pa.]) 1880-1923, 1891-07-11
THE LYMPH DEFENDED
Richard F. Smiths Review of the Re-
suits of a Years Trial.
MORE RECOYERIES THAN DEATHS.
Interesting Statistics as to the Effects Of
the Treatment.
WHERE THE DOCTORS MOST DISAGREE

The story told by DR.. E. T. Painter, the
Pittsburg physician who visited Berlin to
take the Koch treatment, has revived inter-
est in the lymph and its results. Richard
F. Smith reviews the matter for the Phila-
delphia Public Ledger, saying that 1t is now
nearly a wear since Robert Koch announced
the discovery of a compound which, intro
dueed by injection into the circulation,
would confer immunity from tubercular dis
ease, and even arrest the progress of such
disease when already present. The result
of this announcement is still fresh in the
memory of all; the widespread excitement
among professional and non-professional
alike: the rise of unreasonable hope, so soon
depressed by unreasonable despair; the final
disappearance of the lymph from the arena
of popular discussion, and its relegation to
that limbo where reside the thou
sand and one discarded consumption
cures of the past. Readers, however,
are aware that this popular dismissal
of the lymph was not paralleled by scien-
tiic rejection. There was, to be sure, a
period of distrust and depression, but it
served only to prepare the way for an era of
more cautious and unpreiudiced experiment,
which has already witnessed much advance
in the knowledge Of the proper use and
therapeutic value of the famous drug.
Germany has of course, been the principal
field of experiment, and we must accord
inglv look 10 German scientists for opinions
of the most weight. Their utterances in
recent months have been neither few in
number nor slight in Importance. The
Dcltscbe N63jeiniScbe HocbnSGEu'Jt devoted a
number of pages in each issue to the pub
Of 4ha ,rbo
have handled the lymph, or 'tuberculin,"
as, it is now called; and it is intended
here to give a resume of the results and
opinions detailed during the last three
months
The Opinions Are Conflicting.
1t is, of course, to be expected that no
perfect consensus of opinion concerning
the manv different uses of tuberculin has
yet been reached. And vet in some par
ticulars there is a decided approach to this,
and even where this variety of judgments is
greatest, it is not wholly uncertain in what
direction the majority tend. The value of
ruberculin in the diagnosis of doubtful
cases is, perhaps, the subject of least con-
tention at present It has been found that
some patients, undoubtedly tuberculous, do
not show the characteristic general reaction
after injection; while others, III whom no
by careful post-mortem examination, have
reacted in q marked and unmistakable
manner Accordingly it is concluded that,
as diagnostic, tuberculin is valuable aid
to other means, but can hardly become the
sole reliance of the physician. In this re-
spect, then, kOch's estimate of his dis
covery seems to have been exaggerated.
Passing to the use of tuberculin in the
treatment of tuberculosis, we find some
thing like a consensus regarding its value in
cases where the skin, Joints or throat are
the parts affected. Regarding lupus (tuber
culosis of the skin), DIR. Kuemmel, of Ham
burg considers that Koch's expectations
have been wholly fulfilled. Only one of 10
patients treated bv him failed to show
marked Improvement, and he affected some
wonderful cures. One was that of an 49,
year-old Girl, whom he had at various times
for ten years treated by every method
known to him, but without effect: A few
weeks Of the new treatment accomplished
the cure.
Numbers of Cures Reputed.
This experience finds many parallels, and
in general there seems to be no dissent from
the Judgment of DIR. Heuck, of Heidelberg,
that "tuberculin is at present the best and
most rapidly acting palliative remedy for
lupus" Whether a veritable cure has in
some dispute, but the question seems to
hinge entirely on the definition of "cure."
No one denies that the majority of patients
treated have been constantly progressing
toward a condition that even the most eX-
acting would be willing to term cure, and
the expectation Of eventually reaching it is
considered wholly reasonable. The same
NAV be said in regard to tuberculosis of the
bones or joints, the results gained being
about on a par with the foregoing.
In tubercular affections of the throat re-
suits that are undeniably remarkable have
been obtained. A striking case is that de-
cribed at length by DR.. Renvers, of the
University Clinic, in Berlin. A woman af-
hicted with very severe tubercular ulcera-
tion of the iarvnx and pharynx had been
treated by him four months, in accordance
with the most approved methods, but with
out effect Recourse was then had to tuber-
culin. The patient was at that time able to
swallow nothing but liquids, and that only
with the greatest pain, while her usual con-
dition was one of intense suffering. Slight
relief followed the new treatment at first,
but after the 2Sth injection such decided
increase of the trouble was observed that
the treatment was abandoned for few davs.
AT its renewal a marked Improvement was
shown, and after Is more injections the
woman was dismissed as entirely cured.
More Than Half Restored.
Dr. Moritz Schmidt, of Frankfort, cured
% cases out Of AZ treated, a result consider
ably better than any obtained by the use of
former methods. Equally good results,
however, are reported from other quarters.
Out Of 10 mild cases treated by DR. Gra-
brewer at the Moa5it Hospital in Berlin, s
were completely cured, 8 were so much i'm
nrONpl thai q was confidently nrp-
dicted and only . remained unchanged
Facts like these place the value of tuber-,
culin in this class OF cases beyond dispute.
1t Is when We turn 10 pulmonary tuber-
culosis, or consumption, that we find the
real field of controversy concerning the i'm
portance of koch's discovery. All shades
OF opinion are here found, from the fullest
confidence to the deepest. distrust. One
physicians experience coinpels him to
think that incipient consumption can be
cured with certainty by the new method;
while another has concluded that its use is
little short of criminal in consumption at
any stage. Some are operating on all cases
offered; while others have thrown away
their hypodermic needles and renewed their
allegiance to alcohol and creosote.
Dr.. Rosenfeld, of Stuttgart, for example,
saws that, while formerly he felt obliged to
send a consumptive, if his purse was large
TO health resorts, such as Falkenstein and
Davos, or, II his purse was somewhat larger,
10 Italy, Egypt or Madeira, now he can
let him stay ut home and be treated there
la this way the patient saves not only much
Iaoney, but also much time, since what for
Llcrly would be accomplished only in
months and years is now to be attained IN
from four to six weeks On the other hand,
Dr. Arendt, of Konigsberg, holds that, in
Il