This explains the remarkable phenomenon that in organs newly attacked with tuberculosis, for instance in guinea pigs' spleen and liver, which then are covered with gray nodules, numbers of bacilli are found, whereas they are rare or wholly absent when the enormously enlarged spleen consists almost entirely of whitish substance in a condition of coagulation necrosis, such as is often found in cases of natural death in tuberculous guinea pigs. The single bacillus cannot, therefore, induce necrosis at a great distance, for as soon as necrosis attains a certain extension the growth of the bacillus subsides, and therewith the production of the necrotizing substance. A kind of reciprocal compensation thus occurs, causing the vegetation of isolated bacilli to remain so extraordinarily restricted, as, for instance, in lupus and scrofulous glands. In such cases the necrosis generally extends only to a part of the cells, which then, with further growth, assume the peculiar form of riesen zelle, or giant cells. Thus, in this interpretation, follow first the explanation Weigert gives of the production of giant cells. If now one increased artificially in the vicinity of the bacillus the amount of necrotizing substance in the tissue, the necrosis would spread a greater distance. The conditions of nourishment for the bacillus would thereby become more unfavorable than usual. In the first place the tissue which had become necrotic over a large extent would decay and detach itself, and where such were possible would carry off the inclosed bacilli and eject them outwardly, so far disturbing their vegetation that they would much more speedily be killed than under ordinary circumstances. It is just in looking at such changes that the effect of the remedy appears to consist. It contains a certain quantity of necrotizing substance, a correspondingly large dose of which injures certain tissue elements even in a healthy person, and perhaps the white blood corpuscles or adjacent cells, thereby producing fever and a complication of symptoms, whereas with tuberculous patients a much smaller quantity suffices to induce at certain places, namely, where tubercle bacilli are vegetating and have already impregnated the adjacent region with the same necrotizing matter, more or less extensive necrosis of the cells, with the phenomena in the whole organism which result from and are connected with it. For the present, at least, it is impossible to explain the specific influence which the remedy, in accurately defined doses, exercises upon tuberculous tissue, and the possibility of increasing the doses with such remarkable rapidity, and the remedial effects which have unquestionably been produced under not too favorable circumstances. Of the consumptive patients whom he described as temporarily cured, two have been returned to the Moabit Hospital for further observation.