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 |   Related post: or that the organism tolerates the poisons which the bac- Mirtazapine Mg teria produce, and thus the germs, although present, do not occasion the Mirtazapine 30 Mg symptoms of the specific disease. Much may be urged for Mirtazapine 15 and against either of these theories ; the fact remains that a greater or less degree of immunity as a rule results, and may be artificially produced. There can be no doubt that the substances which de- stroy the disease germs, or which confer immunity directly or indirectly, are Buy Mirtazapine Online contained either in the bacteria or in their secretion products, and, so far as we approach a per- fect condition of Purchase Mirtazapine virulency and favorable growth of the germs outside of the living organism, we may hope to ob- tain these substances from their artificial cultures. It is well known that guinea-pigs are highly susceptible to tuberculosis ; when they are inoculated with virulent cul- tures and with sufficient numbers of the germs the disease follows a rapid, definite, and fatal course. In Koch's experi- ments, made upon animals inoculated from the same culture, and with like quantities, the disease was allowed to develop to its unmistakable recognition ; then certain of the animals were treated with tuberculin, while others for control were kept under the same conditions without treatment. In these control animals the disease pursued its usual fatal course, whereas the treated animals again improved, and outlived the control animals by considerable periods; some finally succumbed to the disease in the end, others were killed for examination, after various periods of treatment, and in the latter the evidences of previously present but healed tubercular lesions were unmistakably demonstrated, although Buy Mirtazapine more recent processes pointed also to the fact that the old lesions were not all entirely recovered from. Feb. 2, 1895.1 VON RUCK: WHAT IS TUBERCULIN? 143 Professor Klebs took up this experimental work in guinea- pigs immediately after the announcement of tuberculin and carried it much Order Mirtazapine Online further, and he has also shown that In guinea-pigs treated with tuberculin previous to tubercular infection the disease followed a much slower course, and that the tubercular lesions produced by inoculation had undergone retrogressive changes and in some cases entire cure. So far as guinea-pigs are Mirtazapine 15 Mg concerned, Professor Koch, and more particularly Professor Klebs, have proved beyond controversy that tuberculin has a curative influence, and the latter has also proved that it confers a certain degree of im- munity, varying according to the time for which the treat- ment was carried out and the amount of tuberculin used. The unexpected toxic eSect of large doses of tubercu- lin in the human subject at once limited its use for the treatment of human tuberculosis, and, while guinea-pigs bore doses of several hundred milligrammes and improved under them, disaster followed from much smaller doses in man ; and persistence in Mirtazapine 45 Mg the use of large and evidently poisonous doses for therapeutical purposes brought the rem- Mirtazapine Discontinuation edy into discredit, as it was not supposed that doses much smaller than necessary for the curative effect in guinea-pigs could be of value in the treatment of the human subject. There were, however, conservative mei* among the pro- fession who, appreciating the unmistakably favorable influ- ence of the remedy upon the animal, and recognizing that, despite the disasters in many instances, it acted curatively in man also, looked for a safe method of application by reducing the doses to such as showed no toxic effect what- ever, and who, under careful selection of cases, hoped to still take advantage of the curative properties. Their re- Mirtazapine Buy sults justified their faith. For myself, I can say that I have so applied the remedy for three years and a half, and that I have every reason to be satisfied with the results I have obtained, while, with the exception of my first few weeks of experience, I have never ob.served a single instance, in over twenty thousand injections since made, where the remedy acted detrimentally or produced undesirable symp- toms or discomfort in my patients. Tuberculin was not all one could desire, but it was a help — indeed, an important one Mirtazapine 30 — and, never having had faith in panaceas, nor ever expecting that we should get 15 Mg Mirtazapine them, I was glad of the addition to my resources, hoping that something better might come in the future. In the meantime Professor Klebs and others undertook further experiments with the view of improving tuberculin by eliminating its toxic properties, the former devoting his entire time and energy to the subject. Those interested will find a full account of the course of his investigations in his work on tuberculosis ; my space will only permit me to mention that he found tuberculin to contain alkaloids soluble in alcohol ; toxines, or toxalbu- mins, precipitated by sodic iodide of bismuth ; while an- other albuminous Mirtazapine 30mg substance, a sozalbumin, was found in the alcohol precipitate. All these substances were sepa- rated and tried upon guinea-pigs and other animals, and it was found that to the alkaloids were due the depressing and injurious effects upon the heart ; to the toxalbumins, the fever, malaise, and Mirtazapine 45mg inflammatory effects ; while the soz- albumin was free from these properties. With the latter substance, now called antiphthisin. Professor Klebs has cured guinea-pigs entirely, and kept others alive for long periods, while the control animals perished under the usual course and manifestations of tuberculosis and in the usual short periods of time. In the human subject its application in doses up to several Mirtazapine Tablets thousand times greater Order Mirtazapine than permissible of tubercu- lin has produced no 30 Mg Mirtazapine depressing effect upon the heart, no fever or inflammatory symptoms, and no other undesirable effects, while it has shown the same favorable curative influ- ence as upon guinea-pigs, and under proportionally larger doses to a much greater degree than had been obtained from the use of tuberculin. It still remains to be shown what the effects are of the substances contained in the bodies of the bacilli of tuber- culosis, and highly interesting and probably important re- sults may be looked for from this Buy Cheap Mirtazapine line of experimentation, which Professor Klebs began in the past year and is now pursuing further in the laboratory of this institution. When these experiments are concluded we shall have each substance contained in tuberculin in an isolated form, and, so far as they are available for therapeutic purposes, we shall be able to use them separately or in various com- binations, according to the nature and particular indication of a given case. Antiphthisin is unquestionably the germicidal part of tuberculin ; it is obtained from the culture fluid from which the germs are previously filtered out ; it is therefore Mirtazapine Online a se- cretion and excretion product of the germ. To answer Dr. Denison's question more directly, I would reply that tuberculin appears to be a complex substance containing toxines, toxalbumins, and germicides (sozalbu- mins), as well as alkaloids (ptomaines '.). 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