Medicine: Tuberculosis at Bay

Recent progress in knowledge of the tubercle bacillus gives color to hopes that the deadly little beast may in the near future surrender unconditionally to the siege of preventive medicine. The most interesting med-cal news of the week was the, announcement by Dr. Georges Dreyer, professor of pathology at Oxford University, of a successful method of inoculation in tuberculous guinea-pigs and other animals.

Bacteriologists have long used anilin dyes of various colors to ” stain ” different species of bacteria. The tubercle bacillus does not stain easily, but when it does, it clings tenaciously to the dye, in spite of immersion in alcohol and strong acids, and for this reason is called ” acid-fast.” Non-acid-fast bacteria (such as the typhoid bacillus) yield readily to the ” antibodies” produced by the injection of dead bacteria of the same disease. But the acid-fast germs are encased in or contain fatty cells called ” lipoids,” which resist digestion when injected into the body and thus generate no antibodies. Dreyer’s idea is to pickle the serum consisting of dead tubercle bacilli in formalin, a solution of formaldehyde. This eats away the fatty cells of the tubercle bacillus, which can then be digested by the body juices, and calls forth a plentiful supply of the antibodies when injected. They in turn attack and destroy the living germs of the disease. Dreyer inoculated three tuberculous guinea-pigs with his defatted dead bacilli. Another pig he did not treat. It died, but the three began to improve immediately, and all signs of tuberculosis soon disappeared.

Dr. P. Fildes and Dr. George T. Western, of the London Hospital, used the Dreyer treatment on human tuberculosis patients with ” benefit obviously greater than from any other form of treatment in use.” If the disease was not too far advanced, the patients improved in temperature and weight, tuberculous joints cleared up, tubercle glands in children diminished, ulcerations of lupus (a tuberculous skin disease) were healed. Dreyer and his colleagues caution against premature jubilations, but state that results so far are incontrovertible.

Professor Dreyer is the son of a Danish naval captain, and was born in Shanghai. He was educated at Copenhagen and Oxford, and has been a professor at Oxford since 1907. He is the author of The Assessment of Physical Fitness.

The Spahlinger treatment for tuberculosis (TiME, April 21) is still gaining adherents in Britain. Beyond the fact that it is a serum, little is known of its details, nor whether it resembles Dreyer’s in principle. Spahlinger apparently objects to investigation until he can secure financial support. It is reported that the British Red Cross and the Ministry of Health may come to his aid.

Dr. Wassermann’s new serum (TiME, March 31) is not a method of immunization, like Dr. Dreyer’s, but simply a blood test to determine the presence of active tuberculosis. Combined with a successful specific, it might cut the tuberculosis deathrate to the vanishing point.

Recent American experiments have approached the tuberculosis problem from the chemical rather than the bacteriological side. The calcium-carbon inhalation treatment advanced by Dr. P. Nolan, of Jeannette, Pa. (TIME, May 12), has been criticized by the

Propaganda Department of the American Medical Association, which has done valuable work in exposing quackery. While not definitely condemning, it finds that Nolan’s ” fibriform” treatment is essentially secret in composition, is put forward on a basis of inadequate tests, and is being commercially exploited in connection with an instrument sold only by the promoter.

Dr. H. J. Corper, of the National Jewish Hospital for Consumptives, Denver, has shown experimentally that carbon dioxide (carbonic acid gas) has an inhibitory effect on the growth of tubercle bacilli.