nych, które stworzyła pożywka larwowa, wymaga opracowania wszystkich postaci gruźlicy i oparcia znalezionych uczuleń na datach liczbowych.
S t r e s z c z e n i e
Wirusowo-reckettsiowa natura zarazka gruźlicy, dotąd stale tłumaczy tak często spotykaną w miejscowym zakażeniu skóry dążenie zarazka do przenikania do krwi, do wywoływania stanów septycznych i do przechodzenia miejscowego zakażenia gruźliczego w chorobę całego ustroju.
Zagadnienie wirusowej odczynowości skórnej w gruźlicy, rozpatrywane w niniej
szej pracy przykładowo z punktu widzenia możliwości metodycznych, które stwo
rzyła pożywka larwowa, wymaga opracowania wszystkich postaci gruźlicy i oparcia znalezionych uczuleń na danych liczbowych.
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J ó z e f K u b i c z
SKIN TESTS IN TUBERCULOSIS S u m m a r y
Though in the Typhus Institute (Prof. Weigl) tuberculose suspected persons were
€xcluded from lice feeding, it was found there, that two feeders of infected lice, towards the end of the feeding period, suffered from lung tuberculosis and ulti- mately died from it. In the case of one feeder with tbc. pulmonum fibrosa, who fed sterile lice larvae on her blood when she had fever, the lice larvae were red and ded.
Basing on these observations the author used the lice larvae method for culti- vation and differentiation of tuberculous germs. The cases of meningitis basilaris (1), tbc. cutis papulo-necrotica (2), pleuritis exsudativa sinistra et tbc. pulmomm apicalis cavernoso-caseosa progrediens were investigated, but only in cases of meningitis basilaris and tbc. cutis papulo-necrotica some acido-resistent granuies were obserwed. Suspensions of tbc infected larvae injected intraperitoneally to guinea pigs produced specific pathological lesions in them.
Lice intestinal suspensions injected as antygen intradermally to tbc patients produced utricaria — like reactions persisting 1—2 h, and disappearing almost without any sign of inflammation after 24 h. After some such injections freąuently the exacerbation of generał symptoms of the disease were observed. The potato- glicerol cultufes from lice tbc granuies, injected intradermally in phenolated physiological salt solution to: tbc. patients gave usually after 24 hours inflam- matory infiltration reactions resembling the Mantoux test. The germs grown on Petragnani medium injected in the same way to original or other tbc patients produced after 3 h. strong urticaria — like reaction and inflammation, persisting 8—14 h. and disappearing within 24 h., leaving only livid macula or little infiltration, With cases of clinically and anatomopathologically different diseases and with healthy persons the skin reactions with described antigen were often negative.
In the case of guinea pigs, inoculated subcutaneously with lice larvae tuberculosis suspensions (1,2) from 2 intestines only Uttle nodules were observed locally lasting up to ten days; after that period they were resorbed (a). 0,3 ml of the suspension grown on Petragnani medium (1 month old) of the germs from infected larvae (1,2) produced with guinea pigs in those conditions the nodules or ulcerations after 12 14 days in place of inoculation (Koch phenomenon) b) With guinea pigs a), b), treated subseąuently after 2 months subcutaneously or intradermally with tuberculosis larvae antigens (1,2), only local oedema or urticaria-like erythema was observed.
But when the Petragnani medium or potato-glicerol isolations (1,2) or antigens was
applied, subcutaneously or intradermally, it produced strong infiltration or ulcera- tion during 2—4 days.
The healthy lice intestines and the described culture media were used as Controls.
Conclusions: The urticaria-hke type of skin reaction after intradermal application of tuberculosis rickettsia-like germs should be regarded as first reaction of the skin, which is sensitized to natural, unaltered tuberculosis granules. The infiltration type of skin reaction in cases, where the potatoglicerol or Petragnani medium antigens were injected, is due to morę or less degenerated tuberculosis germs, which on unoptimal media change some of their ąualities. Sensitised skin cannot decompose the tuberculosis bacilli bodies with aid the urticaria mechanism: but destroys them with the aid of inflammatory reaction. The Koch phenomenon (b) is due to both dead and live tuberculosis bacilli; live bacilli, transformed less or morę in rickettsia like bodies, easily penetrate into the organism and sensitize the skin. Firstly, in place of inoculation, the dead ones produce the symptoms of local inflammation or ulceration, afterwards, when complete resorption is impossible.
With the aid of the injection of lice „per rectum“ by WeigTs method (the lice 12—14 days old), with tuberculosis bacilli acidoresistent type from Lowenstein culture medium, the reversible transformation of the bacilli (lice fed on the skin of idiot child free from tuberculosis) into the rickettsia-like bodies in lice intestines has been observed after 4—6 days; the lice excrements and intestines were examined with nigrosin and Ziehl-Neelsen stains.
Conclusion: The culture media used until now as compared with the parasite intestinal ones, are morę suitable for differenciation than for cultivation of tuber
culosis germs. The tuberculosis germ may exist in the infected lice intestines and in human organism at the early stage of the disease as rickettsia-like bodies;
in the inflammation and allergic conditions of an organism and on unoptimal culture media they grow as bacilli.
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