The substance under consideration-Tuberculin-is, probably, the most powerful agent ever introduced into medicine. In describing its action, Hime says: “It is a tremendously powerful substance. An ordinary injection represents 0.001 mgr. of the liquid. This contains only about the 1-1000 part of active material, or about the fifteen millionth part of a grain. Yet this infinitesimal fraction can set the whole body of a man weighing two hundred pounds in such a state of change that the whole is raised to a temperature of 104 degree or 105 degree F. The weight of the mass thus affected is infinitely greater than that of the active agent, the exact proportion being about 1- 98,000,000,000.
No other substance known to medicine will, in so small a quantity, produce such profound effects. Atropine, Aconitine, Glonoine, and even the snake-poisons, in like minute quantity, would produce no perceptible systemic disturbances.
Tuberculin is a glycerine extract of a pure culture of the bacillus tuberculosis. And yet it appears that it is not identical with any ptomaine produced in the organism by the bacilli in the process of disease. Its exact character is not defined. The active principle seems to be closely allied to protein bodies. That it does not belong to the group of so-called to protein bodies. That it does not belong to the group of so- called Tox-albumins is indicated by the fact that it resists high temperatures and can be readily dialyzed. A precipitate is obtained by the use of 60 per cent. alcohol, which gives a snow- white mass that is almost pure Tuberculin.
This new possesses one property that adds much to its interest. The universal testimony is that it has an elective affinity for tuberculous tissue. Koch says: “There is a general consensus of opinion that the remedy has a specific effect on tuberculous tissue.” To this may be added the testimony of Virchow, who says; “It acts in a remarkably selective way.” Virchow further remarks: “Evidence of its specific power is found in the marked indications of inflammatory action around ulcerated areas and in contiguous lymphatic glands”.
In order to assign this powerful agent, Tuberculin, to its proper place n the homoeopathic Materia Medica-if it is entitled to any such place-two things must be determined: first, the nature of its pathogenetic effects upon the healthy; and second, its curative action when applied according to the indications of these pathogenetic effects.
Unfortunately, there have been no systematic “provings” of Tuberculin, and we must, for the present, depend upon the records furnished by a few experiments. it will be seen, however, on examination of these records, that the pathological effects of Tuberculin are more or less constant and uniform.
In the subject tuberculosis, the injection of a small quantity of Tuberculin is followed by a most profound disturbance of the system. There is great and rapid rise of temperature, and, as set forth by Virchow, increased destruction of tubercular tissue, with its absorption and dissemination throughout the body. This is accompanied by great aggravation of the disease from which the patient already suffers. But it is the effect of the remedy in the healthy subject that we are interested in inquiring into.
Koch relates the results of such experiments. The first subject was Dr. Kitisato, who, June 24th, received an injection of two milligrammes. Four hours after the injection an attack of coughing came on, which continued for three hours. Five hours later, or eight hours after the injection, the temperature was affected, and gradually rose from 97.7 degree to 100.94 degree F. The pulse rose form 72 to 92, and these symptoms were attended by headache, languor, and perspiration.
Dr. A. Wassermann received, June 25th, an injections of 3 milligrammes. In the course of eleven hours his temperature rose from 98.06 degrees to 101.66 degree F., and his pulse form 80 to
92.
Dr. H. Mass received, July 13th, an injection of 4 milligrammes. In the course of the twelve course his temperature rose from 98.6 degree to 102.0 degrees, and his pulse from 72 to 100. He had slight rigors, a feeling of heat, perspiration and vomiting.
Dr. P. Guttman, July 28th, received an injection of 8 milligrammes. Within eight hours his temperature rose from 97.7 degrees to 102.56 degrees F. The pulse rose from 78 to 135. This was accompanied by rigors, heat and sweating.
From these records it may be seen that the pathogenetic effects of tuberculin are as constant and uniform as are those of arsenic, opium or other drugs with known specific action.
The character of its effects may be thus summarized.
After a period of about eight hours from the time of the injection, the reaction begins. First, there is lowering of temperature, followed by a rise, reaching its maximum in about twelve hours. Other constitutional symptoms are: chilliness or rigors, headache, pain in the back or through the body, nausea, vomiting, prostration. Another noteworthy symptom is that there is a short, dry cough, even in provings on healthy subjects, those whose lungs are sound.
Those symptoms subside after twenty-four or forty-eight hours. Provings have not as yet gone beyond the point here indicated. If pushed further, the indications are that it would produce most profound disturbance and even endanger life.
Let us now examine the records of the use that has been made of tuberculin by Homoeopathic physicians.
Reports of cases treated have been made by Drasche, of Austria; Furbringer, of Germany; Jousset, of Paris; Burnett, of England, and Arnulphy, of Chicago.
Drasche treated fourteen cases, six of which were improved and eight aggravated. Furbringer treated forty cases, three of which were cured and fifteen ameliorated.
Dr. Arnulphy’s cases are of exceedingly great interest, both because of the favorable results attained and because they include cases of acute tuberculosis.
The first case Dr. Arnulphy reports is of a young woman, 26 years of age. For six or seven months there had been slight symptoms of pulmonary trouble, consisting of dry cough and emaciation. Suddenly her symptoms became acute, and the disease made rapid progress. She showed great weakness, pallor, great emaciation and almost incessant cough, rapid breathing, temperature of 105 degrees F., profuse perspiration at night and abundant diarrhoea. Over the right lung the respiratory sounds were obscure. The left lung was much affected; at the apex there were moist rales, surrounded by a zone of sub-crepitant rales; at the base, bronchial bubbling rales. The diagnosis was acute tuberculosis and the prognosis grave, if not fatal.
Tuberculin was prescribed. From the first dose the cough abated, the breathing became easier, and in a few days the patient’s condition had so much improved in all respects that she was pronounced to be out of danger. Two weeks later she was cut, and shortly after left her home in Chicago and made a journey to the far west. The woman is still living.
Dr. Arnulphy reports four other cases, all of acute phthisis, which were treated successfully, most of which are as remarkable as the one already detailed.
As a result of his experience, Dr. Arnulphy remarks: Judging by the success achieved, I am justified in saying that the proper field for the activity of tuberculin is acute tuberculosis- precisely those cases which Koch and his followers persistently, and, from their standpoint, constantly refused to treat with the lymph, on account of the reaction that they dreaded.”.
Burnett, of England, reports a number of cases cured; but his records are so wanting in scientific precision that it is impossible to give a satisfactory summary of the results.
The question of great interest is: Is the action of tuberculin in the cure of tuberculosis Isopathic, or is it Homoeopathic?.
In order to answer this, it is necessary again to define the term.
Isopathy may be said to be “The treatment of disease by one or more of its own products”.
One lexicographer, in illustrating this definition, says: “Thus, smallpox should be treated by the administration internally of the various excretions”.
If Koch’s tuberculin has a curative action in tuberculosis- as would now seem to be established from be experience of those Homoeopathic physicians who have already reported on the subject- it follows that the action is isopathic, if the tuberculin of Koch is a product of the diseased process known and recognized as tuberculosis.
Let us see if this be true. Koch’s tuberculin is a preparation made from a pure culture of the bacillus tuberculosis. The bacilli used may be removed two, three or even one hundred generation from the original. A glycerine extract of the medium of culture is made; this is filtered through plaster- of-Paris, and from this an alcoholic precipitate is obtained, which, in attenuation, is the medicinal preparation employed in the treatment of disease.
That the preparation thus obtained is not a product of disease is evident. it is a product of the artificial cultivation of a certain bacillus, which may be removed a hundred generations-yes, a thousand, an indefinite number of generations from the original. It is not a product of disease; it is a product of the test-tube.
