Finally, for my own part, in my articles in L'Art Médical, published three years ago, and in the Hahnemannian Monthly (July, 1894), I have insisted on homœopathic action of the viruses of tuberculosis.
In certain of the pathogenesies of Tuberculin we find thrown pell-mell together symptoms appertaining to Koch's lymph, as well as others which belong to the product baptized by several names, such as Bacillinum and Tuberculin, in the recommendation of which Hering and Swan, and Dr. J. Compton Burnett, in England, have made themselves conspicuous.
Bacillinum—since it must be distinguished from Koch's Tuberculin—is a maceration of a typical tuberculous lung.[G] Koch's lymph is an extract in glycerine of dead tuberculous bacilli. The former is compound natural infection; the latter is a product of laboratory experiment. In the one, various bacteriological species are associated which give, clinically, an appearance of cachexia and of hectic fever; from the other we may sometimes observe vascular, cardiac, renal changes having no connection with the clinical "syndrome" of pulmonary tuberculosis. To place these products together in the same pathogenesy gives an absolutely wrong sense, and the fact that both contain Koch's bacillus gives no excuse for confounding them. In my opinion there are, from a homœopathic point of view, distinct differences between Bacillinum and the Koch's lymph.
Experimentally Koch's bacillus, like many other microbes, does not reproduce a clinical symptom-group; and we homœopaths must have an assemblage of clearly-defined symptoms before prescribing a poison on homœopathic principles. Such is unfortunately the case with many other microbes in pure culture. The experimental diphtheria does not resemble clinical diphtheria. The pneumococcus, pathogenetic of pneumonia, is met with in many other diseases, such as pleurisy, salpingitis, meningitis, etc. Koch's bacillus, too, sometimes remarkably mild in its effects, and seeming to meet with no reaction in the system, evolves aside as in the verrucous tuberculosis; while at other times nothing is able to arrest the action of this terrible microbe, and the world still waits in vain for the man who shall find the means of combatting it. The toxins of tuberculosis are far from reproducing clinical tuberculosis; yet even here we find a curious aspect sometimes assumed by certain poisons drawn from the pure cultivation of microbes. We cannot produce with Tuberculin symptoms analogous to those of real tuberculosis—as it is possible, for instance, to produce tetanus with the toxine alone, Tetanin.
As a general rule, in the case of a healthy man, Koch's lymph would not develop any reaction, its effects manifesting themselves in a febrile congestion, which betrays the presence of tubercles. In our pathogeneses (those of Mersch-Arnulphy), we note the following symptoms—"catarrhal pneumonia with soft hepatisation, and tendency to abscess formation; at post-mortems it is not a gelatinous or fibrinous exudation which oozes out from the alveoli, but an opaque and watery fluid; 'never,' so says Virchow, 'is there found the characteristic lesion of croupous pneumonia.'" A pneumonia from which issues an aqueous and opaque liquid! I confess I do not understand it.
Experimentally this same lymph of Koch gives symptoms of inflammation of the arteries which are not found in clinical tuberculosis.
Animals inoculated with progressive doses of Avian tuberculin, or with serum of tuberculous animals, undergo wasting and loss of appetite, and other general symptoms. They may die of cachexia, or may develop an isolated abscess; but they do not present characteristic symptoms as they would under the action of Cantharis, of Phosphorus, or of Lead.
Finally, inoculation with dead bacilli may produce real tuberculosis.
In the pathogenesy put forth by homœopathists, pulmonary symptoms do not occupy a prominent place. Dr. Burnett, who has experimented on himself with Bacillinum, notes at the end of his symptoms, after the headache, a slight and almost insignificant cough.
In explaining the clinical forms of infectious complaints, we are frequently forced to admit the increasingly preponderant part played by association of microbes—as it is the frequent case in diphtheria—and especially the modifications which depend directly on the disposition of the organ attacked, and not upon the action of the microbe itself.