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.