Page:Popular Science Monthly Volume 38.djvu/635

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DR. KOCH'S METHOD OF TREATING CONSUMPTION.

the employment of labor is constant, and the planter can estimate closely what the yield will be for a given time. The old plants are easily replaced by the suckers that have been previously cut off and kept for this purpose. These advantages are shared by all the cultivators of sisal; but, in addition, the planter in Florida will have at his door a market that now absorbs eighty-four per cent of all the fiber produced. He will not only bring into use land now almost worthless, but will probably make for himself a fortune and introduce a new industry into the United States.

 

DR. KOCH'S METHOD OF TREATING CONSUMPTION.[1]
By G. A. HERON, M. D., F. R. C. P.

GENTLEMEN: This demonstration is given at the request of my friend Dr. Koch, who desires that in London and elsewhere his method of treating tuberculosis should, so far as is at present practicable, be open to the inspection of the medical profession. Certain parts of this work are already established upon a basis of clinical observation. Other parts of it remain still to be worked out. I think practically all that is yet known to be of consequence in the work is stated in Dr. Koch's paper, which was published in Berlin on the 14th of last month—a paper which has excited more wide-spread interest than any other contribution to medical literature. As a matter of course, you are all familiar with the details of the paper, and I propose to do no more to-night than to touch briefly upon those parts of it which it seems to me are essential to the understanding of the method of the administration of the remedy to our patients, and to a clear apprehension of the obvious results which follow its use in human beings. The mode of action of the remedy within the body is not yet fully known. This much, however, is certain: tubercle bacilli are not destroyed by it in the tissues. It is upon the living tubercular tissues encircling the tubercle bacilli that the remedy produces its effect, and Koch says of this action that there is, "as is shown by the visible swelling and redness, considerable disturbance of the circulation and, evidently in connection therewith, deeply seated changes in nutrition, which cause the tissue to die off more or less quickly and deeply, according to the extent of the action of the remedy. ... To recapitulate" he goes on to say, "the remedy does not kill the tubercle bacilli, but the tubercular tissue; and this gives us clearly and definitely the limit that bounds the action of the remedy. It can only influence living tuberculous


  1. Address delivered at the City of London Hospital for Diseases of the Chest, December 1, 1890.