Tuberculin treatment / by Clive Riviere and Egbert Morland.

Date:
1912
Catalogue details

Licence: In copyright

Credit: Tuberculin treatment / by Clive Riviere and Egbert Morland. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    entirely cannulled (Chart HI). To obtain the same efficiency a larger dose must be given, and this is fol- lowed by a further rise of tolerance (Chart 111), which again needs an increased dosage to overcome it. Thus we find that, whether we desire it or no, tolerance must always be taken into consideration; we must either Avait for its disappearance or we must raise the dose if this is to remain effective. Now the mechanism of tolerance is hard to under- stand, and it cannot be said that any explanation so far attempted covers the facts. It is clear that the tuber- cular sensitiveness is not exhausted but only encroached upon, since a sudden increase of dose wiU at any time caU forth a reaction. The tuberculin is activated, but the nervous system and focus of disease are by some means protected from it. This may be by the pro- duction of an antibody, and the presence of such an antibody in conditions of tolerance has been demon- strated by the use of the complement-deviation method of Bordet and Gengou and spoken of non-committaUy by Wassermann as antitubercuhn (Chart I). Its in- crease and decrease has been shown by Pickert and Lowenstein to take the form of a curve like that of the tuberculo-opsonic index and Ave may accordingly associ- ate immune opsonin, and antitubercuhn together as parallel if not identical phenomena. SUMMARY. We may sum up shortly the physiological action of tubercle products (tubercuhn) as foUoAvs:—■ 1. In the healthy no action at all.