CARE IN THE USE 
• OF 
Tubercle Bacillus 
AS A REMEDY IN 
TUBERCULOSIS. 
By SAMUEL G. DIXON, M.D., 
Professor of Bacteriology, etc., Academy of Natural Sciences. 
Reprinted from THE TIMES AND- REGISTER, February 28, i8<)i. 
PHILADELPHIA : 
The American Medical Press Company, Limited, 
1891. CARE IN THE USE OF TUBERCLE BACILLUS 
AS A REMEDY IN TUBERCULOSIS. 
By SAMUEL G. DIXON, M.D., 
Professor of Bacteriology, etc., Academy of Natural Sciences. 
AFTER a careful study of the action of the toxic 
substance found in the tubercle bacillus, upon 
the human economy already the victim of tubercu- 
losis, I venture to cite a few facts regarding the same. 
The first case is that of a man who presented him- 
self at a hospital for treatment; without fever ; with 
small whitish nodules scattered over the pharynx; 
slight cough, and dullness over the right apex; 
tubercle bacilli in sputum. Injection of the new 
remedy produced an ulceration of the entire pharynx 
and a sloughing of the same, tubercle bacilli being 
found in the slough. After treatment for six weeks 
the patient lost over twelve pounds in weight. The 
dose was increased to ioo milligrammes. He died 
the day following the ioo-milligramme injection, of 
acute miliary tuberculosis of the intestines, heart, 
liver, kidneys, pleurae, omentum, etc. The history 
of this case points strongly to the probability that the 
acute miliary tuberculosis developed during the treat- 
ment of the case, owing to the fact that the patient 
did not develop an abnormal temperature before the 
injection of the remedy. 
From this and many other cases, I feel quite well 
satisfied that, if by treatment with the new remedy, 
we set up an extensive ulceration that perforates any 
of the vascular membranes, we must expect a general 
tubercular infection. 2 
Another case of death caused by the treatment was 
by perforation of the tubercular ulceration through 
the walls of the intestine. 
Just here I beg to call attention to the fact that 
tuberculosis of the sesophagus, stomach, and intestine 
are very liable to acute exacerbation under the action 
of this organic remedy. 
Another unfavorable case worthy of mention oc- 
curred quite recently under Fraenkel. He had a 
case of tubercular phthisis, with consolidation and 
without cavities, that in the course of treatment de- 
veloped by metastasis, tuberculosis of the tongue. I 
may also mention a case of a child with knee-joint 
disease, that developed by metastasis during treat- 
ment, seven solitary tubercles in the brain, each one 
at least one-fourth of a centimeter in diameter. 
At present, I regret to say that I fear our remedy, 
as generally prepared from the tubercle bacillus, is 
much more valuable as a prophylactic than as a 
curative agent, yet I have not by any means given 
up all hope of its having remedial power. Its diag- 
nostic power, shown by experimentation on the human 
economy, has fully corroborated my experience with 
it on animals, yet I am not ready to affirm that it 
does not react also on other pathological conditions, 
while its action on tuberculous man does not fully 
corroborate my results obtained in animals with arti- 
ficially produced tuberculosis. I cannot but indulge 
myself with the expectation that the time may be 
approaching when we shall be able, not merely to de- 
stroy tuberculous tissue, but the micro organism that 
we find so intimately associated with tuberculosis. 
In the meantime, if to be used in the human econ- 
omy, I would recommend the most careful adminis- 
tration of the new toxic agent, and even with the 
most favorable cases, that the initial dose does not 
exceed one-half a milligramme, and should the tissue 3 
not manifest a tendency to extensive ulceration, as 
will be shown by a lower or slightly higher degree of 
fever on the days intervening between the injections, 
the treatment may be cautiously proceeded with. If a 
decidedly higher temperature is manifested on the 
intervening days, the welfare of our patient certainly 
demands a discontinuance of the treatment. This, 
however, need not of necessity bar a physician, who 
has seen fit to use the remedy, from making another 
attempt, providing the patient presents more favor- 
able conditions, particularly as there are a few cases 
reported as being much benefited by the remedy. 
In some of Prof. Gerhardt’s cases the catarrhal 
condition of the apices has been reduced, while the 
dullness is gradually decreasing; while Prof. Koch 
has a few cases at the Moabit in which bacilli have 
remained absent for some months. 
As I have never felt sufficient confidence in the 
toxic effects produced by subcutaneous injections of 
devitalized tubercle bacilli, upon the animal economy 
suffering with tuberculosis, to risk its use in man, I 
have, as stated in former communications for some 
time past, been using a long line of other agents, and 
I believe that it is only right and proper for me to 
again call attention of all workers in bacteriological 
investigation to what I have before strongly hinted 
at, when alluding to the effects of food, light, tem- 
perature, etc., upon the growth of the tubercle bacil- 
lus on an artificial culture pabulum. 
Glycerine is one of the substances that I have em- 
ployed in excess since 1889, as specially mentioned 
in previous articles, and with a marked effect on the 
growth of the tubercle bacillus. 
After satisfying myself that I had pretty clearly 
established the effect of an excess of glycerine in the 
nutritive agar agar glycerine medium upon the 
growth of the organisms, I proceeded to introduce 4 
large doses subcutaneously into the animal economy 
where a tuberculous process was going on. 
In the few cases thus treated, there has, to all ap- 
pearances, been produced a marked change in the 
tuberculous process in the animals, therefore to facili- 
tate matters, I hasten to place before my colleagues 
the suggestion indicated as above, and I should be 
very glad if they would themselves try its action in 
the animal economy, and report their observations.