TUBERCULOSIS. 235

be of little value to treat patients who suffer chiefly from
secondary infection, especially with the streptococcus,
and in whom the septic process has put the tuberculosis
entirely in the background."

By proper administration of the TR Koch was able to
render guinea-pigs so completely immune that they were
able to withstand inoculations of virulent bacilli. The
point of inoculation presents no changes when the
remedy is administered, and the neighboring lymph-
glands are generally normal,, or when slightly swollen
contain no bacilli.

One very important objection found by Trudeau and
Baldwin against commercially prepared TR is that it is
possible for it to contain unpulverized, and hence live,
virulent tubercle bacilli. In the preparation of the rem-
edy it will be remembered that no antiseptic or germicide
was added to the solutions, by which the effects of acci-
dental failure to crush every bacillus could be overcome,
Koch having specially deprecated such additions as pro-
ducing destructive changes in the TR. Until this objec-
tion can be removed, and our confidence that our attempts
to cure patients will not cause their death be restored, it
becomes a question whether TR can find a place in
human medicine at all, or must remain an interesting
scientific laboratory demonstration.

Probably the most interesting use to which the TR-
tuberculin has thus far been put is found in the experi-
ments of Fisch,1 who immunized a horse with it, hoping
to produce an antitoxin that might be useful in treating
tuberculosis. His experiment seems to have met with
remarkable success, for the serum thus secured, which
he calls "Antiphthisic Serum, TR," is found to thor-
oughly immunize guinea-pigs to tuberculosis, to cure
tuberculous guinea-pigs in the early stages of the dis-
ease, and to neutralize the effects of tuberculin upon
tuberculous animals.

Upon human beings it is too early to make a positive

1 Jour, of the Amer. Med. Assoc., Oct. 30, 1897.