Prof. Koch's Method to Cure Tuberculosis Popularly TreatedBirnbaum, Max
Science
Prof. Koch's Method to Cure Tuberculosis Popularly Treated
Birnbaum, Max
Tuberculin; Tuberculosis
To make a short repetition, the remedy therefore does not destroy the
tubercle bacilli, but the tuberculous tissue; on dead tissue, for
instance, gangrenous cheesy matter, necrotic bones, etc., it does not
act; nor on tissue that has undergone mortification through the action
of the remedy itself. Living bacilli can still linger in such dead
masses of tissue, which are either cast out with the necrotic tissue, or
may possibly migrate under special conditions into the adjoining living
tissue.
This quality of the remedy must be particularly observed, if its full
specific action is to be obtained. Therefore we must first cause the
mortification of the tuberculous tissue, and then effect its removal as
soon as possible, for instance, by means of a surgical operation; but
where this is impossible and the excretion by the organisms themselves
is necessarily slow, we must attempt by continued application of the
remedy to protect the endangered living tissue from the immigration of
the parasites.
As the remedy acts only on living tissue and causes mortification of
tuberculous tissue, we can readily explain another exceedingly peculiar
property of the remedy, namely, that it can be given in rapidly
increased doses. This may apparently be explained as being based on
inurement. But noting that in about three weeks the dose may be
increased to 500 times the strength of the first one, it is
unquestionably something more than habit, as we know of nothing
analogous confirming such a rapid and farreaching adaptation to any
powerful drug.
This fact can rather be explained thus: in the beginning there is an
abundance of living tuberculous tissue and only a minute quantity of the
effective substance is sufficient to cause a strong reaction; through
each injection a certain quantity of this responsive tissue disappears,
and then relatively larger doses are required to cause the same degree
of reaction as before. Aside from this adaptation may assert itself
within certain limits. As soon as the patient is treated with such
increased doses, and that he reacts no more than one not afflicted with
tuberculosis, we may assume that all the reactive tuberculous tissue is
dead. It is then only necessary to continue the treatment at intervals
and with gradually increased doses as long as any bacilli remain in the
system, to protect the patient from a new infection.
It remains to be learnt in the future whether this conception and the
deductions based thereon are correct. For the present I have directed
the manner of application of the remedy on this basis, which in our
experiments resulted as follows:
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