[For some weeks the country has been seething with the sensational accounts appearing in the daily papers regarding the wonderful work Friedmann is going to accomplish with his antituberculosis serum. There are some, however, who think the whole thing looks like a grand publicity scheme on the part of the German doctor. At any rate, his secrecy, his determination to patent his process, his haste to accept fees for his experimental work, all tend to make the medical profession at large look upon his work with more or less distrust.
In 1903 Dr. Friedmann published four articles in Germany relating to the discovery of tubercle bacilli in the lungs of a turtle which had died of spontaneous tuberculosis in the Berlin aquarium. The germs were found to be “acid fast” and to grow best at a temperature of 98.6°, and to be more like the human and bovine than the avian tubercle bacilli of Koch. As a result of inoculation experiments with this bacillus, all the cold-blooded animals succumbed, but none of the warm-blooded animals except guinea-pigs, and they only when injected with enormous doses.
Friedmann’s fourth article mentioned that the turtle bacillus is especially advantageous for producing immunity. Articles by him appeared in 1904 and 1905, partly in answer to criticisms, but with no new developments. From 1905 until 1912 it appears that no new articles were published over his name, at which time his now-famous article in the Berliner Klinische Wochenschrift (Berlin Clinical Weekly) appeared and attracted wide-spread attention.
At the time of this writing, his cure is being investigated by the Public Health Service, who are according him all the courtesy that seems prudent under the circumstances. Meantime there is manifested a little hysterical haste, as in the case of the congressman who attempted to have a bill passed to grant the German doctor special privilege to practise in the District.
As with all good things, this, if good, can afford to wait until it has been tried out thoroughly. If the doctor is only a hair-brained enthusiast, or if he is trying in this remedy to build up a fortune on the woes of humanity, and is taking this way to advertise himself, we shall have cause later to congratulate ourselves if we have not jumped too hastily at the supposed cure.
The preventive treatment proposed in the following article, and suggested by Dr. Karl von Ruck, is in no way connected with the Friedmann treatment, and is given here rather by way of contrast. This treatment is now under investigation by the Public Health Service, and also by Medical Inspector E. R. Sitt, U. S. N., for the Navy Department.— En.]
AT the meeting of the North Carolina Academy of Science, held in Greensboro, April 25, 1913, Dr. C. A. Julian, of Thomasville, N. C., presented a report of some work done in the Baptist orphanage under his medical charge, which is of far-reaching importance, and the results of which I desire to communicate to the readers of LIFE AND HEALTH as concisely as may be done.
Permit me to say at the outset that the results of the present international struggle against tuberculosis are necessarily as yet unsatisfactory. I say necessarily, because it is only thirty years since the cause of tuberculosis was discovered, and it is little more than twenty years since the general warfare against the disease was initiated. Small wonder, therefore, when the end of the crusade is not by any means in sight! With the tremendous prevalence of consumption and the many ways in which consumptives can infect others, even unintentionally, it is practically impossible for the well to guard themselves and their children against infection; and because of this fact a great fear has developed in the minds of many, which leads them to shun consumptives. The warfare against tuberculosis has degenerated into a warfare against the tuberculous. This is as wrong as it is futile.
Since it is manifestly impossible to isolate all consumptives and to eliminate all possible sources of infection (even if it were well to do so), the only other way, and indeed a far superior way, is to protect the well against the disease, against the consequences of the unavoidable infection (of course, infection can develop into disease only if certain conditions are given), that is, to immunize, or vaccinate, the well against tuberculosis by producing in their blood the power of destroying the tubercle bacilli as they are introduced into the organism.
It is with a remedy which accomplishes this object that Dr. Julian’s report is concerned, a remedy which was worked out after many years of investigation by Dr. Karl von Ruck, of Asheville, N. C.
We understand by immunity the power of the organism to render disease germs harmless, either by killing them or by neutralizing the poisons which they develop or which are formed out of the dead germs, or both. The most satisfactory manner in which germs can be killed is by destroying them so that they are at first broken up into granules and then dissolved without leaving a trace. However, it is necessary that the solution which contains these dissolved germs should no longer be toxic, or poisonous, in order to obviate all further possibility of harm. All these requirements are fulfilled in the prophylactic remedy prepared by Dr. von Ruck, and this can be shown in the following manner: —
If we take a small amount of blood from a non-tuberculous person, and allow the serum (blood water) to separate, and then add to the serum a number of tubercle bacilli, many times more than would be sufficient to kill a guinea-pig, and if we “incubate” this mixture by keeping it at body temperature for several hours, we can then, by examining under the microscope, find all tubercle bacilli un-harmed, and if the mixture is injected into a guinea-pig, the animal will become tuberculous and die in from six to ten weeks, sometimes as soon as four weeks, after infection.
Now suppose we immunize, or vaccinate, that same person with Dr. von Ruck’s remedy, and five or six days later, or ten months later for that matter, take a few drops of blood from a needle prick in the finger, allowing the serum to separate. If we add to this serum the same amount of tubercle bacilli as before and incubate, it will be impossible to find any of them under the microscope after about ten hours. They have been broken up into granules, which, in their turn, are dissolved. And if we inject this mixture into a guinea-pig, it will not become tuberculous. If killed and cut open after three, six, or twelve months, it will be impossible to find any trace of tuberculosis. This means, of course, that the blood serum of the immunized person has killed and destroyed these tubercle bacilli, and it stands to reason that, if this person inhales tubercle bacilli, or if any of them enter his body in any way, the blood will destroy them just as promptly and just as certainly inside the body as we have seen it destroy them in the test-tube.
This is actually what did happen to Dr. Julian’s children. In October, 1911, Dr. von Ruck vaccinated, or immunized, two hundred sixty-two of the children in Dr. Julian’s charge, and in 1912 the latter administered the same treatment to one hundred thirty-one other children. In by far the most cases this was done by a single injection, under the skin of the arm, of a small amount of the remedy; in only a few children who showed evidences of active tuberculosis it was held advisable to give several much smaller doses at intervals of five days, so as to make sure that the children should not become harmed by any reaction that might occur.
It was found that after five days the blood of these children invariably had acquired lytic power, which means that it was capable of dissolving tubercle bacilli and of destroying their virulence, or their power to cause tuberculosis even in so susceptible an animal as the guinea-pig. In other words, the children were actually immunized, and they were found to have retained their immunity many months later by actual examination. The scientific proofs of this experience are published in medical literature.
In regard to the clinical or practical proofs, which anybody can understand, Dr. Julian gives the comparative weight of one hundred nine of the children immunized in 1911 and of one hundred ten of those treated by him in 1912.
Of the former series the records were taken before vaccination and again fourteen months later.
Sixty-six tuberculous children had gained an average of 20 pounds each, or 26.5%.
Twenty probably tuberculous children had gained an average of 13.8 pounds each, or 24.2%.
Twenty-three normal children had gained an average of 8.8 pounds each, or 12.9%
Of the series of 1912 the records were taken before and again three months after vaccination.
Thirty-six tuberculous children had gained an average of 10.1 pounds each, or 16.1%.
Forty-eight probably tuberculous children had gained an average of 13.8 pounds each, or 13.9%.
Twenty-six normal children had gained an average of 3.6 pounds each, or 4.3%. This shows of course that the tuberculous and the probably tuberculous children were not only protected against the further progress of their disease, just as the normal children were protected against its acquirement, but that in the former the nutrition was improved so materially that a curative effect was evident. And, indeed, those children who had had fever, cough, and other symptoms of consumption had lost them entirely; in those in whom the glands on the neck or in the armpits had been enlarged, showing tuberculous changes to have occurred, these glands had either become very small and firm or they could no longer be felt at all. The very much greater gain in weight in the tuberculous and probably tuberculous children over that in the normal children shows that the increase in the former was not only that which we naturally expect in growing children, but that it made up for a loss that had been sustained through previous disease.
Dr. Julian’s report contains many more points that would be of interest, but the space at my disposal is short. What I have said will, I believe, prove the remarkable fact that we have in Dr. von Ruck’s remedy a means by which we can, with a single injection under the skin, and without danger, with almost no pain and without any sore arm, immunize children and adults so that they are protected against tuberculosis.
We can further, by means of a single injection, or at the most by a very few, so increase the resistance and nutrition in early cases of tuberculosis that the disease will promptly be arrested. While in the latter class of cases there will be some sore arms, some redness and swelling, on account of the unavoidable reaction, there are no abscesses and no pustules as in vaccination against smallpox. In most cases the children had nothing at all to say about pain.
I may add that Dr. von Ruck’s remedy does not contain tubercle bacilli, either living or dead, but that it is made from the bacilli by extraction, by a process the particulars of which are published in medical literature.
What this remedy means, not only to tuberculous patients, but to the well, to parents, to children, to the whole world, is difficult to appreciate. In my opinion it is one of the most remarkable, one of the most beneficial, discoveries that has ever been given to mankind.